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<br /> <br />813-780-0020 <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Address 5' " C <br /> <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 I <br /> <br />391)-co <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 /> <br />L ,'1\ Co 1 VI. /i-v <? . lOT # <br /> <br />I PARCELID#I \2 ~ '2 ~ - 2 \ - O0S6c:> --(J0006 " (')O-lol <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />E3 ADD/ALT D SIGN D MOVE D <br />REPAIR <br />c==J COMM D OTHER <br />c==J FRAME D STEEL D <br /> <br />c(tJ A u",("f- <br /> <br />I <br /> <br />DEMOLISH <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER I <br /> <br />c~ <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT <br /> <br /> <br />;1\ 5~c./l) <br /> <br /> <br />BUILDING SIZE <br /> <br />I I <br /> <br />111111"'1""'111"1'1'1""111'1'111""11111111'1'11,,1111"'111"'1111111111111'111"'111"1111'11111111"1111'111"1111"'1111111'11111'11111 <br /> <br />1$ I <br />1$ I <br />1$ I <br />1$ ~/OOO I <br />f <br />D GAS D ROOFING c==J SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I11111111111111111II111111111I1I1111111111111111111111I11111111111111111111111111111111111 <br /> <br />COMPANY I +10~~ <br />REGISTERED I Y / N I FEE CURRENT <br /> <br />License # I <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />D <br /> <br />W.R.E,C, <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />(t ,f"\~ ft -~ <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Y/ N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />License # <br />1111I111111111111111111111111111111111111111111111111111111111111111111I1111II11111111111111111I111I11111111111I111111111111111111 <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 subdivisionsllarge 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 />DI~~~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 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 (Plot/Survey/Footage) <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />