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<br /> <br />City of Zephyrhills Permit Application <br />Building Department Pa5CD <br /> <br />t/3 <br /> <br />lab <br />tIS a00/(0 <br />lit PI- 339f( LOT# I/o/Lf <br />PARCELlD#13tf-;25-:lI- 0 ILlIJ -OtYJ{X)- jCflfO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />1$ ~ /JjO ~ 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 9\[NO <br /> <br />II""" I" , "I""""'" '."".,,' """"., ""","",',' "'." 'I' ':D"'" II'" I' 'I'" I'" ~~.,.;"., ,.,~"'" r',.,""" ,. -;.;;.'" 'I"""" ~"I <br /> <br />BUILDER liI?7 ~ COMPANY I ~r~ IlILu?1Jn ~ 7.h c- I <br />SIGNATURE tv REGISTERED N I FEE CURRENT 1611 N I <br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />e <br />D <br />D <br /> <br />COMM <br />FRAME <br /> <br />ADD/ALT <br />REPAIR <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />~ <br />~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />Glass n:;ol'Y\ <br /> <br />-",-'" ~ <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />BUILDING <br /> <br />D <br />D <br /> <br />PLUMBING <br /> <br />~ <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />NO~-' <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br />'11111111111111'111'111'111111111111111111111111111111111111111111111111111111111111111111111111'1111111111111111111111111111111111111111111111I11 <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, Storm water Plans wi 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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans, <br />--"PROPERTY SURVEY required for all NEW construction. <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111I1111111111111111111111 <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 NC Fences (Plot/Survey/Footage) <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGtoIATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />License # I (L1C.0C261) 77 <br />l!!f&An i;Jedrt~ <br />N I FEE CURRENT 1('0 N I <br />License # I e (!C.. /3:J!; /38':3 <br /> <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N ' FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br />