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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />41 ~ 7 3 Fax-813-780-0021 <br /> <br />Fee Simple Titleholder Name <br /> <br /> <br />Date Recelved <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Address I <br /> <br />1.1gif~~g <br />I <br /> <br />SUBDIVISION <br /> <br />9 tA f){) e... f. -16~ Pi ..j.!IS<l:l <br /> <br />I PARCEL ID#I <br /> <br />D NEW CONSTR ~ ADD/AL T D <br />D INSTALL D REPAIR <br />PROPOSED USE ~ SFR 0 COMM D OTHER <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTION OF WORK Ili>1JAQP 7JfJ1JJ-' A,..tr-&f tJ-1HJJ hn~~) i~'l.L(Jt, of f)<{~) Ir..~ - &Mt?U ~ <br /> <br />BUILDING SIZE I SQ FOOTAGE I J J 0 <!' I HEIGHT I I <br /> <br />."11...11.....'11..111..11...11...11...."....................11.....11....'.11...111...11...1111..........11........11,.......11.1111.11.111.11111. <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />D BUILDING 1$ q <br />I <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />DGAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <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 />~ .I\~ <br />D W.R.E.C <br /> <br />tJd 0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />"IP.p'III....""'II..'II""...II..'IIII"..'...11111'""IIII,tllll....",I'I"I""'IIII,I'lll",,"'111"11"11"""11"'1'111111"111111'" <br /> <br />!. . I <br />BUILDER - <br />SIGNATURE . -zJ4w.,<t. (!.O~ i21Jr:u.<fI1~ <br />Address <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y/ N FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED I Y/N FEE CURRENT Y/N <br /> License # <br /> <br />Address <br /> <br />PLUMBER <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 /> <br />Y/N <br /> <br />Address <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 />Address <br /> <br />1I11111111111111111111111111111111I11111111111111111111111111111111111111111)11111111111111111111111111111111I111111111111111111111111111111111111 <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 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 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 />....PROPERTY SURVEY required for all NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />Directions: <br />Fill oul application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (Ale 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />