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<br />a 13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />it-t~7l/ <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />~ <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />.533 i, <br /> <br />~f.t; sf- <br /> <br />LOT # <br /> <br />I <br /> <br />E3 <br />D <br />D <br />~!~'"' S15,A. Vi C/'i <br /> <br />SQ FOOTAGE I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />[!J <br />D <br />D <br />I <br /> <br />N6-u <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />PARCEl.ID#/ <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />f=/) it. <br /> <br />OTHER I <br />STEEL D <br /> <br />L.ff- -:S~-ho x/ <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />I <br /> <br />,'1111...11"...1....111..11..11,..11,.,...111111111..'11...11...111...1111..........11....111.......,......11.11'.......,.11....................... <br /> <br />D BUILDING 1$ <br />~ ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />HEIGHT I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />viI(" PROGRESS ENERGY <br /> <br />AMP SERVICE <br />/O(J <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />"'111"'1111""1'1"""""""'111""1'"..."...11..'1'....'111111'.."...'11'..""....'1111.'..,....""1'111'1""111111"1111"1""111' <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />~ <br /> <br />~~. <br />.3 8>83i.. <br /> <br />q.'iC, AtJl1 2 - alfJ <br /> <br />COMPANY <br />REGISTERED <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI 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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />1I111111111111I 111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111'11111111111111111I1111 <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 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 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 (Plol/Survey/Footage) <br /> <br />Address <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />