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<br />81:-1-780-0020 <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 /> <br />Date ReceivefJ <br /> <br />\:""" ()JY' W'A- tl ~ ctr- . <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address I <br />"3t.t'54 To u (WVv('~ cl Y" . <br /> <br />t II"N/r~ f'o l...ct <br /> <br />LOT # <br /> <br />I ~1r <br /> <br />JOB ADDRESS <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />E1 <br />o <br />o <br />Liru- <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />(08T AINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />E3- <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I seW ey <br /> <br />I I <br /> <br />I 1111 , IIIIIIII , WI I , , 111111 , I 1III III , I III ,. 111 , , 111111111111' 111 1 III ,. II , , I III ~ .. II . III . III . I , P II , · . 11111 III · I , I P . IIIII1 1111 II111111111111 , , II , III <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE I <br /> <br />D <br />D <br />rn <br /> <br />I <br />I <br />I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111I11111111111I11111111111111111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br /> <br />PLUMBING <br /> <br />1$ <br />1$ <br />1$5oo'~ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />o <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 <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />335 <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <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 />1111I11111111111111111111111111111111111111111111111111I1111I11111111111111111111111111111111111111111111111111111111111I1111111111111111111111111 <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 />.........................................................................................................1..1.....................1.1..1.1111.1111 <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 <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />