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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 />!C{vJ <br /> <br />fl73!JS <br /> <br />Date Received <br />1111111111 <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />'t. Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />F.. S'mpl. TlII.ho'de, Add.... ~ <br />JOB ADDRESS I ~ 2 ~ t}b~~ +t ~.\~ 4\^ . D< . <br />15, \ \IV O\\- ~ S \) -' \..'J-~'^\ I <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />PARCELID#lo3'~26-2..\ ,C'2.0'V......O~OOO ~ oo~D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />~ <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <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 />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />5 <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />OTHER <br />SIGNATURE <br /> <br /> <br />License # <br /> <br />Address <br /> <br />11111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 on site, Construction Plans, Stormwater Plans wI 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 wI 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 />11111111I11I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II11111111111111111111111111111111 <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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />