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<br />8'13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br /> <br />Date Received <br /> <br /> <br />(; lle <br />fie plte14 7 <br /> <br />lif~ <br /> <br />..- Owner's Name <br /> <br />.. Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />-JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~ {/t3(?- <br />I <br /> <br />WORK PROPOSED <br /> <br />)refJ,((2,1j <br /> <br />I PARCEL ID#I <br /> <br />~ ADD/ALT D <br />D REPAIR <br />D COMM D OTHER ,Ke - /)/)OD +'" <br />D FRAME D STEEL D OTHER I <br /> <br />-r;f'< bf?r (. '1'1 e ? 0 ," flea r 54r"/l..5 Ie 5 <br /> <br />BUILDING SIZE I SQ FOOTAGE I "3 ( 0 0 5 ,F I HEIGHT I <br /> <br />......"""."".."1'."'.,,..............,.........,..",.."".,.......,......",..."................",.....,.,......""""""'..1....... <br /> <br />{WhO <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />DESCRIPTION OF WORK <br /> <br />Er <br />D <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />--0 BUILDING 1$ 81?o~ ~~. I <br />0 ELECTRICAL 1$ I <br />0 PLUMBING 1$ I <br />0 MECHANICAL ~~ ROOFING I <br />0 GAS D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.REC. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />Address <br /> <br /> <br /> <br />__ BUILDER <br />SIGNATURE <br /> <br />FEE CURRENT <br /> <br />FEE CURRENT <br /> <br />I fZc ;JCj();1 ~ f;)'~ I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />35{ (.;L <br /> <br />COMPANY I <br />REGISTERED . I Y I N <br /> <br />License # <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />111111111111111 III11111111111111111111111111I111111111111111111111111I1111111111111111111111111111111111111111111I1111111111II1I1111111111111111I <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 subdivisionsllarge 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 wI 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 />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 f 111111111111111 i <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 />Driveways-Not over Counter if on public roadways..needs ROW <br />