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<br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Nlft <br /> <br />Fee Simple Titleholder Address I <br /> <br />I (003 3 <br />bp~( <br />B <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />30 <br /> <br />lJgn ~ On <br /> <br />1111111111'111111111111111111111'111111111111"11111111111'1111"'1'111111111111111111"1111'1111111111111111111111111111111111111111111111111111' <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ 31S"O O.a,.q.. <br /> <br />D GAS ~ ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1I111111111111111111111111111111111 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />D <br /> <br />BUILDING <br /> <br />D <br />D <br />D <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />(\1 rA <br />~o+h st <br />Ble.-<€."Le S~ <br /> <br />LOT # I <br /> <br />Zepn'1rl1J15 I Fe ~ 354;). <br />PARCELlD#lo;J-dh-,;>/- Olfio.-'{)oooo -00"0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />1~e'51ci-f1~ sh (~\l <br />D OTHER I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />D <br />D <br /> <br />D <br /> <br />DEMOLISH <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />(e -'fff <br />I <br /> <br />y-eOJ <br />( oofl <br /> <br /> <br />SQ FOOTAGE <br /> <br />HEIGHT <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y / N <br /> <br />Address t License # I <br />~F CtlYrtra ~~ ~ of- <br /> <br />~~HN~URE -<(' ~ ?4 ~~:~:R~~ I ~Af~1 F~C~RRENTt;'~ Y/N <br /> <br /> <br />Address 14501 SJe.fi ijolLDw Ln fllttt+ Ct~5 License # Ieee 13;) ~<67q <br /> <br />1111I11111111111111111111111111111I111111111111111111111II111I111111111I1I1111111111I1111111111II11II1111111111111111111111111111111111111I11I11II <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 w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />Di~~~ii~~~': 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 />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />