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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 />Date Rec~lved <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple TIlIeholde, Add~' ~ <br />JOB ADDRESS I ?:>~ <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />-r {"j Ll. ( (YY.)C.. \ \ ("\ .e <br /> <br />I <br />B <br />D <br />D <br />w.Jcvck S/nt5 <br /> <br />De.. <br /> <br />PARCEL ID#I B.4 -~~ ._~ \ . 00<30- ODC:Jc.JO .. a7~D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />Idl<6 <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />BUILDING SIZE I I SQ FOOTAGE I /3 00 HEIGHT I <br /> <br />'-'..11,1111..1111..111111..111.1111,111...1111..111..1,...11....1,1111....-'1...11...111...11..1111.,.,1111.......1111.....111...'...11.1111....11.' <br /> <br />D BUILDING I$./v 50 , <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />,..,11...""".11'."1'...,""...'1"....,...,11.'11"'1'1"111'1""-1111111'1....,..,11""1.1"'111""".'111.'...1'...."'.'11"".'111"'... <br /> <br />I VALUATION OF TOTAL CONSTRUCTION <br /> <br />I AMP SERVICE D PROGRESS ENERGY D W.R.E.C <br /> <br />I/z'6ttJ~ A6\,).~ h--t COl'"'~- eV't"\...w-n.d :S\~.~ 1'- j <br />I ~~ ~(\:\- d.~) fii . . .~a, n:..~~ <br />. ~ ~...)...C) c,("'\La...-t Qa.'(SD. . <br />I VALUATION OF MECHANICAL INSTALLATION .::::-o....n~ <br /> <br />D SPECIALTY D OTHER It' <br />I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />OTHER <br />SIGNATURE <br /> <br />cw-- <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />ryS&tV (oNC,c/c- <br />I Y I N I FEE CURRENT I Y / N <br /> <br />Address <br /> <br />Address <br /> <br />License # <br /> <br />111111111111111 11111111111I1111I111111111111111111111111111111111111111111111111111111111111111111111111111I1I111111I1111111I11111111111111111111 <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 />1111I1111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />