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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 />~~l <br />~ <br /> <br />Date Received <br /> <br /> <br /> <br /> <br />,'~ / ?5'iJ <br />Iho~ <br /> <br />Owner's Name <br /> <br />12t'1 ; <br />h -r~ <br /> <br />s-!-. <br /> <br />Owner's Address I 4t8S1 <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />5a-L <br /> <br />LOT # <br /> <br />PARCELlD#1 <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />B <br />D <br />D <br />IJlet,k c.J, ~ y/ e hit,>' L,.:.k <br /> <br />L \t\c.~r I' I <br />"'FOOTAGE 34h <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />o <br />I <br /> <br />o <br />o <br />o <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />DESCRIPTION OF WORK <br /> <br />4'..s-' <br /> <br />BUILDING SIZE <br /> <br />11"1111111111111111111111111."11"111111111111"11"PIII'III,lllt'111111"",'IIII'IIIIIII.II.'IIIII'1111111111'1111111'1"'1111111111"11'111" <br /> <br />HEIGHT I '-I I .rS' <br /> <br />D BUILDING 1$ I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS 0 ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />/4.. 2 lr21- aGIO -O/StX) -rot 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />D <br /> <br />W,R.E.C, <br /> <br />yf6'~ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 OTHER <br />FLOOD ZONE AREA DYES <br /> <br />License # <br />11111111111111111111111111111111111111111111111111111111II11111111111111111111111111111111111111111111111111111I111111111111111111 <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, Stormwater 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 />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />~ <br /> <br />,t:J... sf. <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <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 />COMPANY <br />REGISTERED <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />DNO <br /> <br />kMl uNli..Jtl :j;'lc. <br />I Y / N I FEE CURRENT I Y / N <br /> <br />License # I <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />'1111...11.....1111111.......................................1......................................................"...,.....1........,.....,... <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 <br /> <br />Driveways-Not over Counter if on public roadways,. needs ROW <br /> <br />Fences (PloUSurvey/Footage) <br />