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<br />813-780-0020 <br /> <br />..........1 <br /> <br /> <br />. <br />Date Received <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />~-I{-Ol <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address ~0A <br />, " ...irl' <br />~\ ~~B ADDRESS <br /> <br />1$ I <br />1$ ~50~ I <br />1$ I <br />1$ 4600 ~ I <br /> <br />o ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111I11111111111111111111111111111111111I111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSEI) USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br />D GAS <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ls~ 34 brlJl <br />I <br /> <br />~LlJD <br /> <br />B <br />o <br />o <br />I ti; I~ <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />~35)jI- :2132 <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br />L/ <br /> <br />To/LJ <br /> <br />OTHER 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 />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address License # <br />11111111111111111111111I1111111111I111111I11111111111111111I1111111111II11111111111111111111111111111111111111111111111111111111111111111111111111 <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 subdivisionsllarge 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 wI 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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br /> <br />~~f,.", ~~,es <br /> <br />License # 18T-? 00 J3S-B3 <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br />I ~J/.XR{)tJ()1uJr/l L (!LJrrl$J1J 1<$ <br />I Y I N I FEE CURRENT Y I N I <br /> <br />License # kJJ1~ I fJ / 1 '/72- <br /> <br />Y I N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />iil~~~ti~~~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 . 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 />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 I(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 S'ewers Service Upgrades NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />