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<br />8'13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />- Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />Fax-813-780-0021 <br /> <br />~111~ <br />~oCb( <br /> <br />Date Received <br />I I " I " III I <br /> <br />,,'" Owner's Name <br /> <br />S~+IA S L <br /> <br />- JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />1525"01 ~S~+IA ~'-r. <br /> <br />l:5h~l/ Res=;t M H-P I <br /> <br />~ ADD/ALT D <br />1Kl' REPAIR <br />c==J COMM D OTHER <br />c==J FRAME D STEEL D <br /> <br />.., DESCRIPTION OF WORK IPw N e:W B~ 13oAR.e\ 0 (\j 70 \ e.. 4 rut f'/\.E.- +-G f> A c.K c:> N <br /> <br />I SQ FOOTAGE I I HEIGHT I I <br /> <br />LOT # <br /> <br />- SUBDIVISION <br /> <br />PARCEL 10#1 <br /> <br />_ WORK PROPOSED <br /> <br />~ <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />,.... PROPOSED USE <br />- TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />11"'111"11'1'1111"',1."'1111."".'111"'111"'111.....11.111..1111...".....111....11..111.'...'1..........'..11.."'.'."'11111.111111..'..., <br /> <br />""D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />@ ELECTRICAL 1$ 7. -- 00 I AMP SERVICE c==J PROGRESS ENERGY D W.R.E.C. <br /> ::J/ <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING c==J SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />""'11111"""1"""""1111111"""11111'111"."""111111'111"1111"'1""11111111111111""'111.'"111"11"""'11111""1""."'1""1 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />C:Ef/e <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />~ f: (MJ f\J6/2/ <br />~ FEE CURRENT I <br />License # I <br /> <br />__ ELECTRICIAN! dl. ~ <br />SIGNATURE (j;./C- <br />Address <br /> <br />Y/N <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 />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />1111111I111111111111111111111111111111111111111111111I1111111111111111111111111I1111111111111111111111111111111111111I1111111111111111111111111111 <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 />I1I1111111111I1I1111111111111111111111111111II111111111111111111I111111111111I11111II11111111111III111111111111II11111111I1I11111III111111111I11I1 <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />