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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 Re~ived . <br /> <br /> <br />ffi Q-{L. ~(} <::X3 <br />~~S,--:a:G;~)\ ~ ~'-m <br />300 ~5J dL 54 ~ <br /> <br /> <br />Owner's Name <br /> <br />PARCEL 10#1 <br /> <br />I <br />I <br />I <br />I LOT# I I <br />02... ~--u~OD\ A- -CXXVO-'Dl/O I <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />~ MOVE D <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDR,ESS <br /> <br />~~ <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />SUBDIVISION <br /> <br />SIGN <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />\ ~~S\\,:JLA. \Ajt')\-L -:"-::. \ ~ <br />BUILDING SIZE SQ FOOTAGE I HEIGHT I <br /> <br />.'....111.'..11...1111..11...11..11....'11....111...11....11...,.............11..111.....".'111...11.1'.'.....111111111..'.'.'1111.......111111".' <br /> <br /> <br />DU <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE: <br /> <br />1$ {c \'y) CJ-~ I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />~~:~~~:.""'~.."~'~""..."I""'~:~:"iB;:;."':;~""'~:;"""""""1 <br /> <br />SIGNATURE ~- . .EG~"'ED I Y I N I FEE CURRENT I Y I N I <br /> <br />+=r=- ~I~ ~ License # I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address i l:>{ 5 cp <br />ELECTRICIAN <br />SIGNATURE: <br />Address I <br />PLUMBER I <br />SIGNATURE: <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />YIN <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE. <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />11III1111111111 I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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, Storm water Plans wI 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 />1111111111111I11111I11111I111111111111I1111111111111I1111111111111111111111111111111111111111111111111111111111111111111111II1111I11II11I11111I11I <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 (PloUSurvey/Footage) <br /> <br />License # <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />