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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 />111111111111 <br /> <br />Owner's Name <br /> <br /> <br />Owner.s Address <br /> <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 />I ~ 156 ~ \'\eur \:\:x. ~ 2...0 r"\ ~ 'l> \ II~ ' <br />IC ~ \.br,~ '\>n1.1 PARCELlD#13Y.~5- ;Z\"'OO~O -o:xxo-o5oo <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />El NEWCONSTR f5(l AD~ 0 SIGN D MOVE 0 <br />INSTALL D REPA <br /> <br />PROPOSED USE 0 SFR D COMM 0 OTHER <br /> <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D <br /> <br /> <br />::~L::~:;EOFWORK Ir~ "1U:~:~~~ ~r~~::~ C.:~.:~...I.. ~"......,........ <br /> <br /> <br />1$ 3/,O()O I VALUATIONOFTOTALCONSTRUCTION 351tXX5 <br /> <br />1$ I Dt:J6 I <br />1$ d60D I <br />1$ I <br /> <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />~ <br />~. <br /> <br />D <br /> <br />MECHANICAL <br /> <br />~oc -- ~c.9. <br />S\~ PH'I~' .' <br />VALUATION OF MECHANICAL INSTALLATION -1i. . I <br />:oil ~_ <br />~ <br />DNOS~ <br /> <br />~V'\ <br /> <br />PLUMBING <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />~~i' <br /> <br />I~\e('('~(' 1)ru;-\-.~~-h~ <br />I Y / N I FEE CURRENT 'I. . rYi"N' T. . <br />License # 1c..G-C Ao a'l <il'O <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Address <br /> <br />MECHANICAL I COMPANY <br />SIGNATURE . REGISTERED <br /> <br />Address ! e I <br />~' .kr .~l~O <br />-f ~.:;'::tuRE _ .. - ~ ~ V' ~,:::'.':: <br /> <br /> <br />Address __. I License # <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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) complete sets of Building Plans plus a Life Safety Page; (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 />1I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I <br />Directions: <br />Fill Ollt 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 A1C <br /> <br />~'(i c:::->+ L, ~l.o <br />~ ~ I N r FEE CURRENT <br /> <br />License # I <br /> <br />I ~\""~~~~ 1:\~~\~~Y/N <br /> <br /> <br />License # I <br /> <br />Y/N <br /> <br />Y. ELECTRICIAN <br />SIGNATURE <br /> <br />"* PLUMBER <br />SIGNATURE <br /> <br />License # <br /> <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..n~e~W <br />.- ., <br />-:Y SO('l R.c:>C>YY")~\ 1\ be gFh~~ q Rc>a~()') u..)'i l\be o~g<_cl <br />~ p~ C/1.L~.N""" ~/s..n:sc~\~) _ 5pt.'c.su.:fd\ b..L..(:6<~c.~) <br />