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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br />11111111. <br /> <br />AV'(, <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />, <br />Owner's Name ,)...."..) , <br /> <br />Owner's Address 13 K 7 I ') <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />~ 'LA ~ <br />I <br />~ <br />CJ <br />CJ <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />3'iJ7/7 <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />l}QJ <br />D <br />I <br /> <br />PARCEL ID#W - '2- ~- U,.... DOL c.... 21 2AJD - 006D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ADD/All rn SIGN D MOVE D DEMOLISH <br />REPAIR <br />COMM D <br />FRAME D <br /> <br />SUBDIVISION <br /> <br />(e.A.ci- <br />OTHER I <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br />bel Ff <br /> <br />,. DESCRIPTION OF WORK <br /> <br />)Q (-1- r <br /> <br />UP <br />. <br /> <br />SQ FOOTAGE I <br /> <br />.1/ e Lv <br /> <br />f::p IlJ:- P ~ <br />I HEIGHT I <br /> <br />BUILDING SIZE I <br /> <br />..1....111...,.............11.'..............................................................................................".................1. <br /> <br />-0 ~('3 1$ /000, C C I VALUATION OF TOTAL CONSTRUCTION <br /> Ve'/!'( , <br />0 ELECTRICAL 1$ I AMP SERVICE CJ PROGRESS ENERGY D W.R.E.C. <br />0 PLUMBING 1$ I <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />0 GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11"'..',.,.",....,...,.....,.........'...11".....,.'"',P"I""""""""p","',",p",,",,"',,"',,"""""""""""",""""1"" <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 />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />- COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />/kmed}tl .It. e l"- <br />I Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />III11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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) 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 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 />I1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111I111111111111 <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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />