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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's Address <br /> <br />Fee Simple Titleholder Namel:5353 <br /> <br />C::>+ Y\ "5 <br /> <br />F.. Simp" TIIlehold" Add...._ L ;;;; ~; / ~ ~' <br /> <br />JOB ADDRESS I ~ 5353 ~ s+ I LOT # I <br /> <br />I I PARCELlD#U \ - rl~ - ~\ - 60\0-09700- cmio <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />E3 ADD/ALT D SIGN D MOVE D <br />REPAIR <br />c==J COMM D OTHER I <br /> <br />BLOCK~fj{i "71t1~ lAP <br /> <br /> <br />I SQ FOOTAGE I I HEIGHT I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />.11....11...11.....11..111..111.1111...111...'111..111.......111..111.'..'.,...........'.....11.............111111.....11111...."................. <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE c==J PROGRESS ENERGY 0 W.R.E.C <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING c==J SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111.'..'1""1'..."11....."'11"'....111.",,1,...111'11"1.111"'111..,,11..111...111111'1'...11"....11'11..'..111'....".1111.'.'111'...'1 <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111I11111111111111111111111111111111111111111111 <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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111 <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 AlC Fences (Plot/Survey/Footage) <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br /> <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br />