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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 />Date Received <br /> <br /> <br />~o~ <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fe. S;mpl. Tlllehold" Add'e.. ?~:;~ <br /> <br />JOB ADDRESS I ~ <br /> <br />SUBDIVISION <br /> <br />c ,R... -;) L( "[ "- S-r. <br /> <br />I PARCELlD#1 tJ2-2~-21-0D~O -DOC-oo -OotO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />E3 NEW CONSTR E3 ADD/ALT D SIGN 0 MOVE D <br />INSTALL REPAIR <br />PROPOSED USE D SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />DESCRIPTION OF WORK I hon ~\v...D Ur )4-- LJ~ ~S <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I <br />111111111'1111111111111111111'1111111'11'111111111111111'11111111111111111111111111'11111111'111111'111"1111111"11111"1111'1'111111111'111111'1 <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL 0 <br /> <br />OTHER I <br /> <br />D BUILDING <br />D ELECTRICAL <br />I::x:J PLUMBING <br />D MECHANICAL <br /> <br />I <br />: <br />1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br /> <br />1$ <br /> <br />:$$ <br />. \ Sb 160 <br />~.~ <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 />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />COMMERCIAL <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Address I <br /> <br />PLUMBER 11/ ^ L. '-~ .,.rJ .....1 <br />SIGNATURE .~ ~ . <br /> <br />Address 13~l4l.\ (I< S<i E. Ze-pl,,~yt,ilhl .33511~ <br /> <br />MECHANICAL I 1 <br />SIGNATURE . . <br /> <br />Address I <br /> <br />OTHER 1 <br />SIGNATURE <br /> <br />Address I License # <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II1I111111I111111111111111111111 <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 wi 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 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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />LJ\lll~~ Tl^C, <br />Y/N <br /> <br />License # I c.fGr Lf ~ 5 ~ 0 d-. <br /> <br />FEE CURRENT <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />1..........................1......1.11.11.......................1.11..1..........................1.................1.11.........1.........1...11.. <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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />