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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 />1/103(3 <br /> <br />Owner's Name <br /> <br /> <br />Date Received <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />'" <br /> <br />WORK PROPOSED <br /> <br />. - 2ephLI/Lfu11sJ FL 386<<-/-2- <br />I <br />I PARCELlD#1 <br /> <br />B ~ <br /> <br />PROPOSED USE 0 D <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D OTHER I I <br /> <br />DESCRIPTION O'WORK l'KellO{/l..,4on ~I~ 10 htu..:: ~ STDItL inf", f..isl-fJu{~f. <br /> <br />~~:~~,I~~I~:~~IIII.lIIIIIIIIIIIIIIIIIIIIIIIIIIIIII~~ I~~~~~~I~ III (~~, ~~~ f!., I~ 1111 ~I~~~~~' .'1111111111" 111111111111111111111"1""" 1111 <br /> <br />Fee Simple Titleholder Address I <br /> <br />17d~S- c'aI/ IJ' vd <br />I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />ADD/AI./) 0 L SIGN <br />REP AI)1(e/Jpy" o..:n Dt) <br />COMM c=J OTHER <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D MOVE 0 <br /> <br />DEMOLISH <br /> <br />9 <br />B' <br />ca-" <br /> <br />t;~fI.L- 1$/j~ ()oo. - I <br /> <br />ELECTRICAL 1$ 35"O{).- I <br /> <br />1$ ;S-txJ.-- I <br /> <br />1$ I <br /> <br />GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES <br /> <br />111I111111111111111111111111111111111111111111111I1111II111111111I111111111111111111111111111111111II111111111111111111111111111111111111111111I11 <br />. COMPANyT'nIF ~"J/f>, &,4.~ * <br />REGISTERED ."" I Y / N . ,'-FEE CURRENT I'~':/~ I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PLUMBING <br /> <br />AMP SERVICE n ~ <br />911~ <br />D~ ~~tP~ <br />~ <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />PROGRESS ENERGY D WR.E.C. <br />:I IJ b ~/t <br />!JOU <br />~ <br />'l<rrRU~r' ~ ~ <br />DNO ~~ <br /> <br />D <br />o <br /> <br />MECHANICAL <br /> <br />Address <br /> <br /> <br />e.~D'tJqL3 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />JJs:LL/ License # 16 c.. J'3002~ I b <br /> <br />ll:o~54...., P\\J""\o~i\.~ <br />I Y / N I FEE CURRENT I Y / I <br /> <br />License # I'-~c:... ,c.a."L b'L go <br /> <br />I CliYY'~~ Lc~ ~cl,~~ <\ iA.Ji <br />I Y / N I FEE CURRENT I Y / I <br /> <br />License # I <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address License # <br />11111111I11111I111111111111111111111111111111111111I11111111111I11111111111111111111111111111111111111111111111111I1111111111111111111111111111111 <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 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 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 /> <br />......11...11...11...11........11.11.......,11.........................11......111111....11.11111...111111........11.11...11.11...111.111111111111 <br />Directions: <br />Fill out application completely. '30 <;'.c-~ <br />Owner & Contractor sign back of application, notarized ;::::'\<rl' .> <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 />Driveways-Not over Counter if on public roadways..needs ROW <br />