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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 />#IS~~ <br /> <br />Date Received <br /> <br /> <br />Owner.s Name <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 :3 7721- <br />I <br /> <br />() a l<- <br />I <br /> <br />rVl NEW CONSTR CJ... ADD/AL T <br />D INSTALL ~ REPAIR <br />PROPOSED USE D SFR D COMM <br />TYPE OF CONSTRUCTION D BLOCK D FRAME <br /> <br />DESCRIPTION OF WORK I S +0,.- ttje. ,(JlJYYt :s <br /> <br />&'f I v I SQ FOOTAGE I 64 <br /> <br />D BUILDING 1$ 79tJ5. 61) <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />DGAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />tuY\. <br /> <br />C'y-r /~ I LOT# I <br />PARCELID#I 3<f~ 2-S~zA-tooo -/1) ~6o~61()D <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE D <br /> <br />D <br />[J;;;{ <br /> <br />(G <br />.A- <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />BUILDING SIZE <br /> <br /> <br />OTHER I <br />STEEL D OTHER I <br /> <br />Loc~iO"Y\ ) <br /> <br />HEIGHT I 7 ( <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C, <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />/~w. <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />I~d~~ <br /> <br /> <br />License # I <br /> <br />I <br />I <br /> <br />~iNb <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <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 />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N I' <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />III1IIIII1II111111111111111111111111111111111111111111III1IIIIIII111111111111111111111111111111111111111I111III1IIII1II111111111111111111111111111 <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 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 />11I1111I111111II111I11111111I1I11II11111I111111II111111111111I1111I11111111111111111111111III111III1111111II11111111II1111111II11I1IIIII1111111111 <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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />