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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 /> <br />Date Recei'ved 1- O~ <br />Owner's Name 'J 0 e.. <br />Owner's Address I JqIR IS <br />Fee Simple Titleholdl!r Namel <br /> <br /> <br />~flid(}(.. 100J Lot) p <br />I <br />I <br /> <br />Fee Simple Titleholder Address I <br />I 39/p/5 fl1ec.cl(JW()od Loo{) <br /> <br />II'~ uclql) wd &lc.tu I / PARCELlD#1 <br /> <br />B <br />o <br />o <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />BUILDING'SIZE <br /> <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />(5 U 2.1 OJ,+05000DDOf/10 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />o <br />m <br />D <br /> <br />OTHER I p(JlUq" LYl,S;/t,/fr;-Ilo/l.-1 <br />STEEL D OTHER I <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />HEIGHT I <br /> <br />D BUILDING 1$ J.. 3 So.CJO <br />0 ELECTRICAL 1$ <br />0 PLUMBING 1$ <br />0 MECHANICAL 1$ <br />0 GAS 0 ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />y~ License # <br /> <br />COMPANY I <br />REGISTERED 'I Y I N FEE CURRENT <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />1111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 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 />1111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II111111111111 <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 Ale Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />