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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />4....lb-c+ <br /> <br /> <br />fUl\-\- 605CS <br /> <br /> <br />Owner's Address II () i \ 9 <br /> <br />Fee Simple Titleholder Namel ~ <br /> <br />Owner's Name <br /> <br />Sb*' &---. <br /> <br />Fee Simple Titleholder Address 'I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />1)C\....(To ~ CST-- <br />I <br />~ <br />D <br />D <br /> <br />33617- LOT # I DD c:> a <br /> <br />PARCELlD#I't>-~Io- ~l- f)oeo. 00\ 00- oD 00 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />~ 1- ';). '1 <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br />D <br /> <br />AD DIAL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />STEEL D <br /> <br />DESCRIPTION OF WORK ~..(..__ovL l<...~ o..""J, (t., \1&(.. f.t..\~ q'nJ Sk~Y\ ,(.~. <br /> <br />BUILDING SIZE I 1 '0 S'lQ SQ FOOTAGE I HEIGHT I I - 3 h..... ( <br /> <br />TIIIIIIIIIIIII'IIIIIIIIIIIIIIIII'IIIIIIIIIII"I'II'I"11111'111""1111'11111"11'1111111111111'1111""'1"1111111111111111'<11'111'11'1111<1'111 <br /> <br />OTHER I <br /> <br />[jJ BUILDING <br />0 ELECTRICAL <br />0 PLUMBING <br />0 MECHANICAL <br /> <br />1$ 1,8'DD, ~ I <br />1$ I <br />1$ I <br />1$ I <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIIII11111I1111111111111111I1111111111111111111111111I111111111I1111I111111111111111111111111111 <br />~ U".) ()>'I :1cY1tfq I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE , <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />License # <br /> <br />lec.Ct15~lib d-. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y IN FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />~~I ~~# <br /> <br />1111111111111111111111111111I1111111111111111111111111111I111111111111111I1111111111111I111II111111I1111I11111I11111111111111111111111111111111111 <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 onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects <br />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 onsite, 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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />Di~~~ti~~~I: . I . . I . . I I . . I I . . . . . . I . . I I I . . I . . . I I . . . . . . I I . I . I I . I . I I . I I I I I . . I . I . . . . I I I I . . . . . . I . I I . . . I I I I I I . . I . I I I I . I I I I I I I I I I I . I I I I I I I I I . I . I . I I I I I I I I . . I <br /> <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 />~JER PERMITTING (Front of Application Only) <br />~ Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />