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<br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />/H1~ <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />\1 P-?J <br />I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />y C, <br /> <br />z~ ,'/0 I r/. I LOT# I <br /> <br />/ <br /> <br />PARCELlD#I/7"-.i" -J I -d /CJtJ - c!)J.1c!JtJ - dC7U7611 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />lZl MOVE D <br /> <br /> <br />SUBDIVISION <br /> <br />i7tf ~ <br />I <br /> <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />SIGN <br /> <br />I <br />D <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />I I I , , . I I I ~ . I I I I 1 I I , I I I I I I I I I I I , I I , I I I I I . . I I I I I . I I I I , I I I I I I I , I , I I I I I 1 I . , , . I I I , . I I I . I I I I I I I I I I 1 , · I I I I I I I I I I I I I I , . I I I . I I , . I I , I I I . I I I I I I I I I I I I I , I I , I I I <br /> <br />D BUILDING 1$ j ? 'Y tfl ct7 cJ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />Noe V <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />~~I ~~# <br />11111111111I1111111111111111111I111111111111111111I11I1111II11111111111I1111111111111I1I111111111111I1111I1111111111I11111111111111111111111111111 <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 />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 onsile, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meel compliance <br />Attach (2) sets of Engineered Plans. <br />""PROPERTY SURVEY required for all NEW construction. <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br /> <br />LIcense # <br /> <br />Ieee CJ s:-? sl :r <br /> <br /> <br />License # I c(' -- cJO.2-571) <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/ N <br /> <br />Y/N <br /> <br />FEE CURRENT <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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />