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<br />8'13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />4/ <br /> <br />I <br />1 <br /> <br />I <br />I LOT# I 1 <br />PARCELlD#111 - L (p - 2-/-00 I () -/~ 7/0 d-Ou 7tJ I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number 1 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />L~vvol <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br /> <br />D OTHER <br />D STEEL D <br /> <br />2-\ j/CtV <br /> <br />I HEIGHT I <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />LJ/c, <br />/ <br /> <br />2. dO 0 <br /> <br />3 - T A-/5 <br />I <br /> <br />D BUILDING 1$ Lj'?cJU 10 v I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL ~ ROOFING I <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <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 />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />11111111111111111111111111I1111111I111111111I1111111111111111111111111111111111I111111111111111I11111111111111111111111111111111111111111111111111 <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />1 <br />I <br />I <br />I <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 />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />License # I <br /> <br />~~:~~~~ lJy trf~<-~=REN~~~/~ I <br />Address 13-)0 \ 0 SrL ~ L 1i1kK. (14 License # IC(?C()S'7 f S 1 <br /> <br />11111111111111111111111111I1111111111111111111111111111111I1111II1111111111I111111111111111I11111111I111111111111111111I11111111111111111111111111 <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 wI 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 wI 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 />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />I~ <br /> <br />SIGN PERMIT <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 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 AfC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />