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<br />City of Zephyrhills Permit AppliCatiOn <br />Building Department . <br />R:iscD rert11,f Serl/ice..-- <br /> <br />Phone Contact for Permittln '1/3 <br /> <br /> <br />813-7~O-p020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />I O^-U Iv-. v..... ............. I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />6C{ me..- <br />0-rh 6jy~ ?:r!ffht/Is, f[;33'3t~ I LO" 26' <br />I PARCEL 10# /1- .- - 0010- (j ~5Q:) -0 ,q 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR rv4 ADD/ALT D SIGN D MOVE D <br />D INSTALL D REPAIR <br />D SFR D COMM D OTHER <br />CTION D BLOCK D FRAME D STEEL D <br /> <br />ORK I EncJD~ earp:d- ftr RooyY1 ~ r+ton <br /> <br />I 16 X I ~ ISQ FOOTAGE II ~() lj1 I HEIGHT I <br /> <br />1$ t?~{)()~ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D <br /> <br />Fee Simple Titleh I Ider Address I <br /> <br />553/P <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSE <br /> <br />PROPOSED USE <br />TYPE OF CONST <br /> <br />~ <br />~ <br />D <br />D <br />D <br /> <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />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/ Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsile, Construction Plans, Stormwater Plans w/ Slit 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 />DESCRIPTION OF <br /> <br />BUILDING SIZE <br /> <br />PLUMBI <br /> <br />GAS <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D <br /> <br />FLOOD ZONE AREA <br /> <br />FINISHED FLOOR LEVATIONS I <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />~-~ <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />~ <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />OTHER <br /> <br />DYES <br /> <br />~NO <br /> <br />15tu;SI1;.k AJaI1Ill1 ClUJ:. <br />CO/ N I FEE CURRENT I("~ I N <br /> <br />License # I <br /> <br />EledrlG <br />FEE CURRENT I (Y}N I <br /> <br />License # I ~ /300J3~ 3 <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />~/1 <br /> <br />.~ <br /> <br />Y/ N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br />IEijrN'sJtf~ ~~if <br /> <br /> <br />License # I <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Directions: <br />Fill out applicati n completely. <br />Owner & Contra tor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) <br /> <br />Agent (for the c ntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNT PERMITTING (Front of Application Only) <br />Reroofs ewers Service Upgrades NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not ver Counter if on public roadways"needs ROW <br />