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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 />Owner Phone Number <br /> <br />b'bwner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />WORK PROPOSED <br /> <br />I <br />I <br />I <br />n)eUKlYfl A-( r 1+1; \\$ -~5L~' I LOT# I C) q 51 <br />I PARCELlD#134 -0)5-- a I-OI<<f6.()CQX)- 8QSO I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />c=J ADD/ALT D SIGN D MOVE D <br />c=J REPAIR <br />D COMM D <br />D FRAME D <br /> <br />DESCRIPTION OF WORK h=Y\<s~ ,\nt{-, (Ii) t>O men. \e~ t-\-~ <br /> <br />BUILDING SIZE L~IQX. 50 SQ FOOTAGE I" S 54 I HEIGHT I <br />11111111111111"111111-"'1"1111111111111'111111111111111111111111111111111111111111111111111111'1'11111111I111I111111111111111111111111111111111 <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner's Address <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />1378\d <br />r~o A-LJ-\r:c, 2Ot'S <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />~ <br />~ <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />BLOCK <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER ffiOt:) \e w~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />ctJ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E,C, <br /> <br />I'-J '- (' <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />OTHER <br /> <br />COMPANY <br />REGISTERED <br /> <br />~~NT llYN I <br />License # t:c \\ - 0 c:x:x:rA 4- <br /> <br />COMPANY <br />REGISTERED <br /> <br />I~ <br />Y N I <br /> <br />FEE CURRENT <br /> <br />ICVN I <br />~CSl){)OCX)( 0 , <br /> <br />License # <br /> <br /> <br />~ ~CUR"'", 11JIN I <br />License # Ir:.H - OCCiYr~ U <br />I <br /> <br />I <br />I <br /> <br />I <br /> <br />FEE CURRENT <br /> <br />I~N I <br />~M-()3Q1S5 <br /> <br />PLUMBER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />COMMERCIAL <br /> <br />Address fr .;)3 <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />111I111111111I11111II11111111I1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111 J 111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets at Building Plans; (1) set at Energy Forms; R-O-W Permit tor 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 tor subdivisionsllarge projects <br />Attach (3) sets at Building Plans; (1) set at Energy Forms. R-O-W Permit tor 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 all new projects, All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required tor all NEW construction. <br /> <br />License # <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />Dl~~~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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter it on public roadways..needs ROW <br /> <br />-'~-"~ <br />,.J <br />