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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 />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />i r'L <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number l <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />5/ Lj tJ <br /> <br />/0 Ii <br /> <br />sT" <br /> <br />LOT # <br /> <br />I <br />I <br />I : <br /> <br />-- oo3tJ1 <br /> <br />Fee Simple Titleholder Address <br /> <br />WORK PROPOSED <br /> <br />El <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I 5'e I< 1/ f e P':.- <br /> <br />I I <br /> <br />'.'1111...111..11111...,11....'................11...11...............111....1111.........111...1111.............11.......11'.......................... <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />PARCELlD#1 \\ - '2(.,..2\..,. ~)O\O '~SDO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE 0 <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />v p ,~.... ~,l,,'L <br />sa FOOTAGE I <br /> <br />,;?oO A/'lip <br />I <br /> <br />HEIGHT <br /> <br />D BUILDING 1$ I <br /> <br />[21 ELECTRICAL 1$ S !:o. g..s;2-- I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> <br /> <br />It,lllpll"'IIIIII"III,"""III"I',"""III,"',,11"111111:'11""""'111'1"111'1'111'111"1"111'11''11'11"'1'1"11"'1""'11""1"111' <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E,C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />~~:;~:~~:N,~. ~ ~ <br /> <br /> <br />Address __' <br /> <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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) complete sets of Building Plans plus a Life Safety Page; (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 wl.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 />11111111111111111111I111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111 <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. (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 AlC Fences (Plot/Survey/Footage) <br /> <br />License # <br /> <br />-JJ ~ <br />'I Y / ~'1' FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />