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<br />. <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Address <br /> <br />fee Simple Titleholder Namel <br /> <br />5~ I f"" <br /> <br />. '(' <br />/ ~ It.. 3 .J. <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br /> <br />Fee Simple Titleholder Address I <br />5~ J.. , S' <br /> <br />1$ 'J (1'1 s-. .J U <br /> <br />1$ <br />1$ <br /> <br />1$ <br />C]GAS ~ <br />FINISHED FLOOR ELEVATIONS I <br /> <br />D <br />D <br />D <br />D <br /> <br />I LOTI I .~- A- <br />I PARCEL 10#1 II-)(P.. ;)/- CXJ/O., 19 roo.. o.J.A<o1 <br />~ (OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />D NEW CONSTR ADDIAL T D SIGN D MOVE D DEMOLISH <br />D INSTALL REPAIR <br /> <br />D SFR CI COMM D OTHER I <br /> <br />TYPE OF CONSTRUCTION D BLOCK CI FRAME D STEEL D <br /> <br />DESCRIPTION OF WORK I \L \ ~ jl. pUt- S i~ ":':J r' <br /> <br />BUILDING SIZE ISQ FOOTAGE . HEIGH~ I <br />III' p, I ~'I ~", 1111'1'11'1111'1" II,.", III1IIII1I H q ".... "'11111' 'I n,,', "." HI IIH'I II If I Pili" ",,,.. pn'" "'1'111"" In ". p pi II fI,llIl, <br /> <br />I <br />I <br />I <br />~ <br />D <br />I <br /> <br />I ~I!-" j' I-~ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br /> <br />OTHER I <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />CI <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <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 />11111111111111111111111111111111111111111""11"111111111111111111111111'1111111'11"1111111111111"'1"1111'1111'11111111'1'1'11111111111'111111 <br /> <br /> I <br />Y/N FEE CURRENT Y/N <br /> LIcense # I <br /> I <br />Y/N FEE CURRENT Y/N <br /> License # I <br /> I <br />Y/N FEE CURRENT Y/N <br /> License # I <br /> I <br />Y IN FEE CURRENT Y/N <br /> License # I I <br />?r>hY .t~~""T' I <br />IN I FEE ET I Y/N <br /> License # I tC(O 13d f"rO\- I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <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 onslte, Construction Plans, Stormwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlsions/iarge 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 onslte, Construction Plans, Stormwater Plans wI Slit 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />Directions: <br />Fill out application completely, <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement 15 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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />