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<br />81-3-780<00'20 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />t-ax-1l1 J-/llU-UU<!l <br /> <br />~~&Df <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />o <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />El <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />I LOTI I <br /> <br />PARCEL ID#III- Z(g ~ 2{ -()o, 0' 05700- 0 tEa <br />(OBTAINED ~~rOPERTY TAX NOTICE) <br />o SIGN . MOVE D DEMOLISH <br /> <br />D <br />D <br /> <br />'5' A V'4 ~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />~~ ""U <br /> <br />* <br /> <br />\}J,'"" .c <br /> <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />~.L:..t~ <br /> <br />.:S2, )1 <br /> <br />COMPANY <br />REGISTERED <br /> <br />~e,~ e. IrleJv ~C.""(I XlI\C. <br />'1 Y/ N I FEE CURRENT I Y/N I <br /> <br />License # I f;c 1300 13S '3 <br /> <br />~'c)'~f)1- gb1... 2-1Mli, FL 3'3-> 1'\ <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />1111111111111111 , 111111111 , II " 1111111111111111 , 111111 , III , 1111111111111111111111111 , , 111111111111111111111111111111 , 111111111 " 11I111111111 " 1111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction, <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Slit Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislonsllarge projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction. <br />Minimum ten (10) wOrking days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />11111" 1111111111111111111111111111 " 11111111111111111111 " 11111111111111111111111111111111111111111111111111111111111II111 i 1111111111111111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC Fences (PloVSurvey/Footage) <br /> <br />. '''-Not over Counter If on public roadways..needs ROW <br />