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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 />Owner's Name <br /> <br />(p- 1 - 0 7 <br />II~ /J-A- 1G5. <br /> <br /> <br />Date Received <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />-;{"J}lf <br /> <br />jB <br /> <br />/lyG- <br /> <br />Fee Simple Titleholder Address <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELlD#II/~,::z~-2/- (}C/tJ -/t'CoO- IJCJI/) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE ~[)EMOLlSH <br /> <br />WORK PROPOSED <br /> <br />8 <br />o <br />CJ <br />I t~~[Ol')r <br />I <br /> <br />o <br />o <br />o <br />)/1; fI" t: i 6- )- <br />I <br /> <br />r=l ~DD/AL T <br />rn--- REPAIR <br />o COMM <br />D FRAME <br /> <br />lLJP{ <br /> <br />SQ FOOTAGE I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />1 <br /> <br />111111'1'1111'111'11111111"111111""'1111'111"1111111"1111'1111111"11'111'111111111'111'11'1111111"11'11'I"IITlllll,II'II'III'III'lll'IIIII,I, <br /> <br />~ BUILDING:: '"I <br />L-I ELECTRICAL . . <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS ~OFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111I1111111111111111111111111 <br />I <br />I <br />I <br />I <br />1 <br />I <br />I <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />D <br /> <br />W.R.E.C. <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 onsite, Construction Plans, Storm water 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 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 />DI~~~ti~~~':' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <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 />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers. Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />~1L-; <br /> <br />D ;; (Ji. I J , 7 <br /> <br />/JAIJ c; t H <br /> <br />/L <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y I N <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/ N <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />YI N <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br /> <br /> <br />i CO /:/,11-/0:: <br />FEE CURRENT <br /> <br />License # I R-c I) 0 C; 6 L' Y / <br /> <br />