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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 /> <br />Date Received <br /> <br />/' Owner's Name <br /> <br />/' Owner'sAddress 1.2f51 DLlS 7rro me'''-)\' A\.t <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />1_3'8l.c4S <br />I <br /> <br />/' JOB ADDRESS <br /> <br />LOT # <br /> <br />17EO{lI~ Avr- <br />. <br /> <br />I PARCELlD#1 <br /> <br /> <br />B <br />D <br />D <br /> <br />D <br /> <br />D <br />D <br /> <br />LoC506. <br /> <br />BUILDING SIZE sa FOOT~E I ;) It) (.}. HEIGHT I <br /> <br />111"'111111"1111111"'1111111111"1'1111""'111111''1"'111"1111"""1111'11111111111111111111111111111111'111"'11111111111111111'1111"1111 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />-t='iNC-C - <br /> <br />D BUILDING -I $ 0:::-.t ~5(). 0<' I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS D ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />0i <br /> <br />35- 21-.5'-2\ - 005C). 00000 -. C(o' 0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />"" <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br />11111111111111I11111111111111111111111111I111II11111111111111111111111111111111111I111111111I11111111111I111111111111111I111111111 <br />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 />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br /> <br /><<~~ <br /> <br />()uJ,uE~ . <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />..11....11...1111...11..11..1111.1111.1111........1111....1............11............11111111...........111.1111...11111111111111................. <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 />