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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 />f~q11 <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <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 />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 3g O:J.. 1. JjV'uLof/c tA-( CulcA <br /> <br />I p~o ,~iki I'+'-~ uJJ- <br /> <br />Cl- NEW CONSTR C:=J ADD/AL T D <br />~ INSTALL ~ REPAIR <br />~ SFR ~ COMM D <br />TYPE OF CONSTRUCTION D BLOCK lli FRAME D <br /> <br />DESCRIPTlONOFWORK I f-......~ /10/ l.JJ,u- ~ <br /> <br />BUILDING SIZE I ~ FOOTAGE ;)@ r--;IGHT I <br /> <br />14ue.. <br /> <br />PARCEL 10#1 :5 ~. ~S- - cl.1- tp-)O- ~-(0:).:2\ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />LOT# I <br /> <br />;A <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br /> <br /> BUILDING 1$ 771 {} . Qc) I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE C:=J PROGRESS ENERGY 0 W.R.E.C. <br /> } <br />D PLUMBING 1$ I <br /> 0't~ <br />D MECHANICAL 1$ ~ VALUATION OF MECHANICAL INSTALLATION <br />D GAS I;1<f ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1"'111111111111'11111111"11'1'111'111111111111"'1'111111""'1"'11'1'1"11'11"'1"1"'11'11"111'11'11'"111""1111111111'111'1111111'111111 <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 />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 />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <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 License # I <br /> <br />OTHER I 12 Li VI ~ . Ro, "" ./ ~ "I::.e <br />SIGNATURE 11, ; N I F~EN.T..J I Y IN' I <br /> <br />Address License # I CCc.- I "3;' r SO ,.C <br /> <br />111111'1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction. <br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ 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 onslte, Construction Plans, Stormwater Plans w/ 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 /> <br />1II1I1111I1III1111111111 J 1111111111111 J 11111111111111111111111111111111111111111111111111111111111111111111111111111 J 1111111111111111111111 1111111 <br />Directions: <br />Fill out application cDmplBtely. <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 (PloVSurvey/Footage) <br /> <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />