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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 /> <br />\ <br />Date,Received <br /> <br />Owner's Name <br /> <br />Owner's Address I '-10 ':!:. -2 I <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />01--1 AJ--i C c:y 1(1) <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />~ <br /> <br />T- <br /> <br />LOT # <br /> <br />PARCEL ID# \<6 - 2& ~ '2-2- bO I o. o'6L\- 00. <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />l.-lo4/s <br />I <br /> <br />, , <br />, <br /> <br /> <br />I <br />B <br />D <br />D FRAME D <br /> <br />i~jK~/OIf A)v,k) oJT ~~ (DS <br /> <br />BUILDING SIZE I I SQ FOOTAGE I /i .ISo I HEIGHT I <br />11"11111111111111"1'11111111111'1""1111111111111111111111'111111111"'1111111111111'111111111111111111111111111111111111111111111'111111111111 <br /> <br />1$ I <br />1$ I <br />1$ I <br />1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />StJfiA'F'f.5 s' 6J-vst IA-C- <br />I Y / N FEE CURRENT I Y / N I <br /> <br />License # I C'J)C /.25'2129' <br /> <br />C( 4.?~ .4 a~ <br />I FEE CURRENT Y / N I <br /> <br />License # I i=c.- ~~?O <br /> <br />COMPANY I Ct'k5T +~ u,1f?, ,f,;fdf.,f <br />REGISTERED I Y / N I FEE CURRENT I 'v / N I <br /> <br />License # I C-re o5"tj,7(<<'p I <br /> <br />I <br />I <br />I <br />I <br /> <br />B <br />D <br />D <br />I <br /> <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br /> <br />,RD <br /> <br />'7- c= (? 1--( t <br /> <br />'F <br /> <br />DO <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />~L"b&~ <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 />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />I ttJ~~1 k/~R <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address I fl'z- ~. rI/)~Y:> Av< #ttlblf/f <br /> <br /> <br />MECHANICAL I I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111I1111111111111111111111111111I1I111 <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 />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 />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />+<V6f <br />I Y / N <br /> <br />Y/ N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/ N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />.111..11111..111.....,11111..11....1111..11.11..11..............................111........11111...11,...111...................................... <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 Attomey (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 if on public roadwaysooneeds ROW <br />