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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 />Date Received <br /> <br /> <br />R..6,J/ <br />l j (!'vi. IS 6t. LAN.]) ~r..v I j)~ <br />'1 {ioN/. 4S !C- E....J I <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name Of\,( <br /> <br />Owner's Address I ((5 2 { <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address Ii 0 ? I '7 7 ( yv1 /S6K 4,1J"d P Fe> r "'" ; PI: <br />I~~( bJ~ q;f <br />I <br /> <br />111 n/l pfJ <br /> <br />Pi- ~S67? <br />LOT # I <br /> <br />SUBDIVISION <br /> <br />2Cplf GiC fJ(cL5. <br /> <br />I PARCELlD#1 J q .- '2.. {, -.. '2- ( ~ 0 (> (0 - 0 I S;;-oO -oo{ (:) 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D NEW CONSTR ~ ADD/ALT D SIGN D MOVE D <br />D INSTALL D REPAIR <br />D SFR D COMM D <br />D BLOCK D FRAME D <br /> <br />I I~&L~ <br /> <br />I SQ FOOTAGE I <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />1111111111111"1111"1111111111'1111111'1111""1111"'11III"tllllllll'IIIIIIIIIIIII"""IIIIIIII'111111111111111'111111111"'111111"'11111'"11'111' <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 />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII1111111I1111111111I111111I1111111111111111111111111I11I11I11111111111I1111111111111111111111 <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 />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br /> <br />License # I <br /> <br />(SJ fN tvE-fL <br /> <br />Y / N I FEE CURRENT <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />111111111111I1111111111I1111111111I1I111I111I1111I1111I1I111111111111I111II1111111111111111111111111111111I1I111I11111111111I11111 <br /> <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 onsile, 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 />Di~~~ti~~~': . . . . . . . . . . . , , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I I . . . I I . , . I I . . . . I . I I . . . I I , . . . I . . . . I . . , . . . I I . . . . . . . . . I . . I . . . . . . . I I . . . . . . . . . I . . . . . . . . . . . . . . <br /> <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (A1C 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 A1C Fences (PloUSurvey/Footage) <br /> <br />Address <br />1111111111111'1 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />