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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 RecE!ived <br /> <br /> <br />- (3--01 <br />AL.L. .. 77ZcH A-1 <br />I 3S147 t&;rh <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />~/-$11 <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />III1IIIIII <br /> <br />Owner's /IIame <br /> <br />Owner's Address <br /> <br />Fee Simpl'e Titleholder Namel <br /> <br />A-v Ii:.- <br /> <br />Fee Simple Titleholder Address I <br /> <br />S~fZ.- <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br />lj, I ?Jf~//vk <br /> <br />PARCELlD#lJJ .. 1,{p... '),{.... DO(O- 004-00 AX)'U <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />I ~,lV5TJf 1/ <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br />STEEL D <br /> <br />~d~ <br /> <br />OTHER I <br /> <br />1$ '12W'~ I <br />1$ I <br />1$ I <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 />111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111II1I11111111111111111111111111111111 <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <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 / N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <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 <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address License # I <br /> <br />OTHER(~ COMPANY 8(///1)/';-16- ~Wj\/~r<... <br />SIGNA~E REGISTERED I Y / N I FEE CURRENT I Y / N <br /> <br />Add",ss ~ ~ - - U,,",e' <br />111I111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111I1I1111111111111111111111111111111 <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 />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 />Y/N <br /> <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If ovelr $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 />