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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 /> <br />U,III4r1IJ~ ~ <br />I (0/ 3S- /O.;./.. 8~ <br /> <br /> <br />Owner Phone Number 8 J S - 7>>..3 - <;&80 <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br />(PI 35" lo.fL 81, <br /> <br />IySDYI Sv.bO. <br /> <br />LOT# /33 <br /> <br />PARCELlD#1 c::>? -l(...- .,2;\ - G:!flO - OO';;l 00. 63'.3 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />~ <br /> <br />I <br /> <br />E3 NEW CONSTR c=J.J" ADD/ALT D <br />INSTALL CJ2r REPAIR <br />PROPOSED USE ozr' SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />DESCRIPTION OF WORK I L (l.",~ _ ~,-<:',Iu'1! l..s <br /> <br />BUILDING SIZE .SQ FOOT~GE I I HEIGHT I <br /> <br />'.....,.........1111.11........................................................................................................................... <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />1$ 4(,~D. ce <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS IT2f <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />o <br />o <br />o <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />...,....",.."..""",.,.""",....."."",........."""11"""".........1..'1"'.".,...,.."""",."..................1.'1..1.....11.. <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER ~JP?I4i\ ~ .t :~ :z;... <br />SIGNATURE I/Y / N I FErlUmd:NT I Y / N I <br /> <br />Address License # I ecc- I,] 2 S"j'"{) r <br /> <br />I1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 onsile, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements musl meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111 <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 AlC Fences (Plot/Survey/Footage) <br /> <br /> <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />