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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />F~-813-780-~'l '~5 <br /> <br />Date Received <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address ~A <br /> <br />! 3'8\0, fYlUrt-e-t .s~ual('e I <br /> <br />I I PARCElID#I 02-2<0 -Z( -0010- o3Q Cb- 0030 <br />(OBTAINED FROM PRa'ERlY TAX NOlICEI <br />SIGN 0 MOVE 0 <br /> <br />LOT# I <br /> <br />SUBDIVISION <br /> <br />..p. \--e. <br /> <br />E3 NEWCONSTR ~ ADD/ALT 0 <br />INSTALL D REPAIR <br />PROPOSED USE D SFR 0 COMM 0 OTHER I <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME 0 STEEL 0 OTHER I <br /> <br />DESCRIPTIONOFWORK Ll fl.s+ctfJ od;lH-,OY\ --t-c <+iv-e.atpt1M .,S;~J:-+e.m <br /> <br />BUILDING SIZE I I SQ FOOTAGE It 670.sr.b-J HEIGHT I I <br />~~~UfflftmtfltiIlUlWflllUIrIHJBIRlImlftHlfDlMllflfll,"mltlmmRnrwlJlfmtllllflRlJHlUltII <br />o BUILDING IS I VALUATION OF TOTAL CONSTRUCTION <br /> <br />~ ELECTRICAL 1$:::2<..{ 20. ,- I AMP SERVICE 0 PROGRESS ENERGY <br /> <br />D PLUMBING 1$ 1 <br /> <br />o MECHANICAL 1$ I <br /> <br />o D ROOFING 0 <br /> <br />I <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />o <br /> <br />WR.E,C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />1~~<-fJ.-L <br /> <br />u::.L!::!-J FEE CURRENT Lr.L!::U f 1:> ~~~ <br /> <br />License # I EFo<'>C078s I <br /> <br />IIlIlIfIllllJIIIlIIItIllllIllllIllllJlJlllRlllllllllllIlllIllllllllllllllIllllll_IIIlIlIIIlIIIIIlIIIIlI1IHIHl <br />Attach (2) Plot Plans; (2) sets of Bwlding Plans: (1) set of Energy Forms; R-O.W Permij for new construction, <br />Minirrum ten (10) working days after subrrittal date, Required ensite, Construction Plans, Slormwater Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site IM>rk Permit for subdivisions/large projects <br />Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy ForITS, R-O,W Permit for new construction, <br />Minirrum ten (10) -ing days after subrrittal date, Required ,",site, Construction Plans, Slormwaler Plans wi Silt Fence installed, <br />Sanitary Faciliti8s & 1 dumpster, Site 'oo'Iobrk Penn~ for aN new projects All commercial requirements rnust meet compliance <br />Allach (2) sets of Engineered Plans, <br />---PROPERTY SURVEY required for all NEW construction, <br /> <br />COMPANY <br />REGISTERED u::.L!::!-J FEE CuRRENT L..1..!..LI <br /> Llcense# <br />COMPANY <br />REGISTERED u::.L!::!-J FEE CURRENT Lr.L!::U <br /> License # <br />COMPANY <br />REGISTERED u::.L!::!-J FEE CURRENT I....:!.ili...J <br /> License # <br />COMPANY <br />REGISTERED u::.L!::!-J FEE CURRENT Lr.L!::U <br /> License # <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />t"\t{i? <br />I\lM.A.t <br /> <br /> <br />OTHER <br />SIGNATUR <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out application completely, <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a Notice Of Commencement Is requlred_ (AlC upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the <>Mler) 'Mluld be someone with notarized letter from <>Mler authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) <br />Reroofs Sewers Service Upgrades NC Fences (PIot1SurveylFootage) <br />Driveways-Not over Counter if on publiC roadways.. needs ROW <br /> <br />nHBmJJJllJlJmlRmmJIFWfIlUOOmlIDflJJfUJflUllffilfJJJlUfflUmDlmUfHijlUDffUlfUlffUfflfJJflfiffRlJfJJOOlIfflffmlm <br />