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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 /> <br />Date Received <br /> <br />Owner's Name <br /> <br />OWn", Add,... I (/1 ~3 <br /> <br />Fee Simple Titleholder Name <br /> <br />Sunni(h)f. Dr; uC <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 />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />Ie; rCLAd <br /> <br />Hotl LcJ1 <:\ I <br /> <br />WORK PROPOSED <br /> <br />~ <br />o <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />BUILDING SIZE <br /> <br />D <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br />~ 00- <br />Address ~C?83?\ ~t'un (-L fc1 7~;~\S ~ ~~CJ I <br />ELECTRICIAN I ~ ~~J AO 10 COMPANY <br />SIGNATURE M REGISTERED <br /> <br />BUILDING <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I fYI (')0' I e <br /> <br />I <br />I--f-cx-oQ _I <br />I <br /> <br />HEIGHT <br /> <br />D <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W.R.E.C. <br /> <br />ELECTRICAL <br /> <br />D <br /> <br />PLUMBING <br /> <br />D <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <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 />rn <br /> <br />D <br />4'/L 11,/0 ~ <br />d~~ <br /> <br />PROGRESS ENERGY <br /> <br />OTHER <br /> <br />dJNO <br /> <br />DYES <br /> <br />I~mr <br />Y/N <br /> <br />LLG <br /> <br />License # <br /> <br />I Y /N I <br />1r:-H-ccm~4 <br /> <br />FEE CURRENT <br /> <br />I'~N <br /> <br />L~~, <br /> <br />I Y /N I <br /> <br />License # B(Y'::ClD(oJ <br /> <br />LQ <br />FEE CURRENT I Y / N I <br />License # 1n+ -CCn:rlC{ Lt <br /> <br />FEE CURRENT <br /> <br />IAfE~ <br />Y / N <br /> <br />FEE CURRENT I Y / N I <br />License # l'--f{:03b1\55 <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address License # <br />11111111111111111111I1111111I1I1111111111I111I111I11111111111111111111111I11111111111I1I11111111111111111111111111111111111111111111I11I11I1111111 <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....111....111........11....1111.,11111......1111.11........11...1..11......11..11111.....111111111111111111.11111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (A/C 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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />