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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813- 780-0021 <br /> <br /> <br />Date Received <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />I I~Zl wJ <br />'~5!R. 33,'rYZ-- LOT # 1,,!Ly- ~ <br /> <br />I PARCELlD#1 \\ - ~ - 21 -~\(2) _0qlJ;(Z(Z) - (Z;(l) I ~ I <br />.-J (OBTAINED FROM PROPERTY TAX NOTICE) <br />M SIGN D MOVE 0 DEMOLISH <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />/" Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />/" JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I G~4 q 4:ttl 5\-, <br />~ If.. L (J)22JlJ5 -(j)7 - ~ <br /> <br />SUBDIVISION <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />El <br />D <br />D <br />~UL <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />370 f-\- <br /> <br />OTHER I r 1''1 "'0..<"'1 - <br />STEEL D OTHER <br /> <br />i I\.S.\-a& <br /> <br />.../ - <br />DESCRIPTION OF WORK <...~ <br />~~:~~,I~~,~~~"" ,I, ,." 0 ~(:.,"" 0" 0'" ]"" .=~), o:a~" 0""" to." ~~~~~~, ,I, ~,',~" 0""""" ,I""" 0""""'" 0"" <br />C2r BUILDING /Ul- 35 <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />o GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111 <br /> <br />BUILDER ......- COMPAN.( I h.oltWL- W J1\/l.-l- <br />SIGNATURE REGISTERED I Y I N I FEE CURRENT <br /> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />Address <br /> <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br /> <br />- <br /> <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br /> <br />I1111111111111111111111111111111111111111111111111111111111111I111111111111111111111I1111I1111I1111111111111111111111111111111111111111111111I1I11 <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 subdivisionsllarge projects <br />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 wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Di~~~ti~~~':' . . . . . . . . . . . . . . . . . . . . . , . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , , . . I . . I . . . . . . . . . . , . . . . . . . . . . . I . I . . . , , . . . . . . . . , . . . . . . , . , , . . . . , . . . . . , , . . . . . . I . <br /> <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 /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />