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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 />1/ 1o'f'f <br />~ <br />c.rrf\ <br /> <br />F.. S;mpl. Tlllehold.. Add..,. I S~ <br />JOB ADDRESS lJoir~ ~ 3 % 7< 3 <br />I <br /> <br /> <br />Owner Phone Number <br /> <br />~~lj~ <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />BUILDING SIZE <br />D BUILDING 1$ 5:90:) <br />D ELECTRICAL 1$ ~ ~r{) <br />D PLUMBING 1$ dJrn <br />D MECHANICAL 1$ d 50D <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS <br /> <br />SQ FOOTAGE <br /> <br /> <br />LOT # <br /> <br />PARCELlD#1 5((+/).; 'd, "~/JJ..";,, ~( <br />(OBTAINED FROM PROPERTY TAX '(>TIed <br />~ SIGN 0 MOVE 0 <br /> <br />EJ OTHER <br />D STEEL <br /> <br />\"....~I J' <br /> <br />7J <br />Xeft~h r . <br /> <br />I <br />I : <br />f1#" ~) I <br /> <br />Fee Simple Titleholder Name <br /> <br />AJ <br /> <br />J'lLn,{ <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />Cl<, 5'1 r <br />I <br />~ <br />o <br />o <br />LJ~ll <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />OTHER <br /> <br /> <br /> <br />Nt"" <br /> <br />I VALUATION OF TOTAL CONSTRUCTION <br />~c:.\ ~(:\n~L <br />I _ ~~ERJE 0 PROGRESS ENERGY <br /> <br />It<, HOec.e\\- PrrR .L <br />$...L'os, <br />I VALUATION OF MECHANICAL INSTALLATION <br /> <br />o <br /> <br />o <br /> <br />W.R.E.C, <br /> <br />Address <br /> <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />License # 1ft: /7 dOl '1.z,'2-1 <br /> <br />;Jt;r/'?10 Fc..hh?ff,~~ r/ <br />Y / N FEE CURRENT <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL ~'_ _ n --.. ,..v-, " ~, r~. <br />SIGNATURE ~ ~-I ....<"J> ~~ <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br />II11II11I11I1I11II1111111111111111111111I111111111111I111II111I1111111111111I1111I111111111I1111111111111111111III11111111I11111111111111111111111 <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 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 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 />~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />lP/ON1b<<'S (') ~, '~-.]o' :an~\i'\ <br />I Y/ N I FEE CURREN,.} I Y/N <br /> <br />License # I <br /> <br />h'\D("~~\cL<- Prlc.- <br />I Y / N I FEE CURRENT <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />~& <br /> <br />~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />DI~~~ti~~~': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <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 (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 PERM,. (Front of Application Only) <br />Reroofs sew--.Service Upgrades A1C Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over~Ui:m public roadways..needs ROW <br /> <br />'1r::.J ':'~:, <br />"". .',' ". . <br />