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<br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />,". Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />. .')( <br /> <br />, 'C . <br /> <br />, Owner's Address 395LiC, q \-h <br />Fee Simple Titleholdl!r Namel <br /> <br />2-hi \\s F l <br /> <br />Fee Simple Titleholder Address I <br />1:3?354(1 <br /> <br />I <br /> <br />q \-h A.0~~ <br /> <br />, JOB ADDRESS <br /> <br />'2- -irlll \ S ~ L 33~ l.j ':).. <br />I PARCEL ID#I <br /> <br />B <br />D <br />D <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />/' DESCRIPTION OF WORK I 'pn \. )(}....O 'j r e rlCl? '..v \."...:_,1-"\._:- ~ - ,I <br /> <br />BUILDING SIZE I I SQ FOOTA~E I I '30 I HEIGHT I I <br /> <br />..'..111...11........11....11........,.........11...,1..II.....p..II.........IIII...II.IIII..II......'...........'r......III......'IIII'IIIII..111111 <br /> <br />D BUILDING ,1$ ~5 40 VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY <br /> <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />DGAS D <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />I <br />o <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />ROOFING <br /> <br />D <br /> <br />WR.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />DNO <br /> <br />OTHER <br /> <br />DYES <br /> <br />11I"'II"'IPI"II"".'."III........II,........,.,.....p....."...."IIIII""IIIII.'II.'II"."""II..,...111.......""...,........'..1111111 <br /> <br />COMPANY Il-\af'r,~(t ~'J ...-....P ,---' <br />REGISTERED I Y / N _ FEE CURRENT <br /> <br />BUILDER ~. ~ ( <br />SIGNATURE .j;\)(r-..o.. ^"~ 0 -L-J~ <br /> <br />Address <br /> <br />Y/N <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <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 /> License # <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />11111111111111111111111111I111111111I111111111111111111111111111111111111111111111111111111111I11111111I11111111I111111111111111111111111111111111 <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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111I111111111111111I <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 A1C Fences (Plol/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />