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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 />tf1 ~ql <br /> <br />Date Received <br />11111111111 <br /> <br /> <br />Owner's Nclme <br /> <br />Owner's Address <br /> <br />Fee Simple TitleholdE!r Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I ~ 805 co2, L Aw ~N.G 4 <br />, <br /> <br />13 'g()7.2 ~At.UfU/tJfi LatJp <br />I iJ 1+'1{;V/),.d W; tiel <br /> <br />1- /) of <br /> <br />2 e Pff'/!f:.)f,' 115 <br /> <br />FL <br /> <br />33~~( <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />5a <br />c::J <br />c::J <br />7Ht7~,,/j~~~ <br /> <br />sa FOOTAGE I <br /> <br />PARCEL ID#I <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 />B <br />ro <br />D <br />I {;/ e {J.1Cf' <br />I <br /> <br />ADD/All <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER I <br />STEEL D <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />I" . 1.1. . I I I U . . , I I . . I I I . . I I . . . I . . . I I . . I I I I . . . . I I I . . I I I . . . I . . . I I . . . , , In' . I , I . . , , I . . . . . . . . . I I I . . , I r . . I ... , I I . r . . . . . . I I I . . I . . . . I I r I . II . . . , . . , . . . . . . . , . . <br /> <br />D BUILDING 1$ 9 CJtJ. t'lL? I VALUATION OF TOTAL CONSTRUCTION <br />D EILECTRICAL 1$ I AMP SERVICE c::J PROGRESS ENERGY D W.R.E.C <br />D PILUMBING 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 />1,.....1'.'111'....11..11..1111'11...11...,.",..",',"'1""""."."""'11"'.'.......'111111"11111111111111""'11"....'11.11.111'11111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />~~. <br /> <br />COMPANY 17~~ <br />REGISTERED Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Addre~js <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURI: <br /> <br />COMPANY <br />REGISTERED <br /> <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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE: <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />1I111111111I111 111111111111111111111111111111111111I1111111111111111111I11II11III11III11111I1I11II1111111111111111111111111111111I1II1I1III1IIIII <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 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 onsile, 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 />m.PROPERTY SURVEY required for all NEW construction. <br />IIII1111I111I1I1111111111I111I111111111111111111111111111111111111111111I11111111111II11111111111111111111111111111111111111I1II1I111111I111111111 <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 A1C Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />