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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />1$1 <-f <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />F.. Slmpl. TIII.hold.. Addms'l d <br /> <br />JOB ADDRESS I 0 7 _ ;;ff) <br /> <br />LOT # <br /> <br />I <br />B <br /> <br />D SFR D COMM D OTHER I <br />o BLOCK ~ F'f':"E /~ STEEL 0 (/ OTHER I <br />I ~O # A v't P (,Iei/!:" = If':-,U, &- <br /> <br />I SQ FOOTAGE I I HEIGHT I . <br /> <br />PARCEL 10#1 <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />B <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />ADD/ALT <br />REPAIR <br /> <br />D <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />.'...11...111...11111..11.......11...11.....'..........111.................-........'.111..1111.............111.'111.....1111...'."11............,.. <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />cfD ELECTRICAL I$~ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11".."'..1'."",..".'.'11'.'......11....'.",.",..".,.,111....'11111111111111'..'11.11111.'1"11111111"""'11""11""""""""'111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <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 />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y /N I. <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111111111111111 I1111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111I1111111111111111 <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 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 />11111III11111111I1111111II111II11111111111I1111111I1111I1111111I11111111III111111I11111I11I111I1111111I111I111I11111I11111111I1111I1II11I111111111 <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 cqntractor) 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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />