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<br /> <br />E:13-780-0020 <br /> <br />Date Received <br />1111111111 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />~ 1 ~ 7 ( Fax-813-780-0021 <br /> <br />,A.- tT.<) <br /> <br />/-- (....1 <br /> <br /> <br /> <br />/P .55//'1 /;/ t/~ ' <br />PARCEL ID#I <br /> <br />LOT # <br /> <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br />B NEW CONSTR fia ADD/AL T D SIGN D MOVE D DEMOLISH <br />INSTALL REPAIR <br />[)Q] SFR D COMM D OTHER I <br />D BLOCK D FRAME D STEEL D OTHER I <br />I If -e iJ /'1 c 'c'-. S Ij;'/V~/c- /fc;p f' tv:. ;( .5 "'y/'_ c}.C. .5 -1 ' '~, ./~ <br />../ , , <br /> I SQ FOOTAGE S-S-O 0 ~ HEIGHT I I <br /> <br />BUILDING SIZE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />I $ /~ ? q- 9. fl,.f2 <br />D GAS ~ / ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />DNO <br /> <br />D <br /> <br />D <br /> <br />AMP SERVICE <br /> <br />PROGRESS ENERGY <br /> <br />WR.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />11111111111..."'...,..".'..'111"""'..1'11.....1.'1111111111......"'11111111....1,.........""""..11.11.".....I"r'I'IIII..........."", <br /> <br />BUILDER <br />SIGNATURE <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 />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />/1 <br /> <br />License # I <br /> <br />~I!f~ <br /> <br />FEE CURRENT <br /> <br />COMPANY I A w't! /Ij <br />REGISTERED ~Y I N I <br /> <br />Y9'? ;17 <br /> <br />(;. <br />I Y IN I <br />rc(" c;$s~"1 9..5' ~ <br /> <br />AJ,,{ ~( <br /> <br />License # <br /> <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 />11111I11111111111111II111II1111I1111111I11111III1111I11111II1111I111111111111II11111111111II11111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIillllllllll <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 />Driveways-Not over Counter if on public roadways..needs ROW <br />