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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 Received <br /> <br /> <br /> <br />Ll/L <br />. <br /> <br />Owner's Name /i1 Ad \/, 'v' tI t~.< I 'c,K...f <br />Owner's Address I ~ If 1 5,'! V( ;L (/),f ~J <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />I <br /> <br />D NEW CONSTR E3 ADD/ALT <br />D INSTALL REPAIR <br />PROPOSED USE 0 SFR D . COMM <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME <br /> <br />DESCRIPTION OF WORK I h L ;/C." T "V --.. ~ <br /> <br />BUILDING SIZE I .. I SQ FOOTAGE I I HEIGHT I . I <br /> <br />."...".,..",..,111.'......,1..."..,11,..........,1,.......'111...'.,....,1,..."...,11...1111...,1,:.".....1,.,11,......1,....,.".11111111'1111 <br /> <br />D BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY <br />D PLUMBING 1$ ~ft' <br />1$ 3.97s'0 <br /> <br />. <br /> <br />D GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />PARCEL ID#/ <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />o <br />o <br />o <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />D <br /> <br />DYES <br /> <br /> <br />1(,9& <br /> <br />~ MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DNO <br /> <br />.'II..PII.....'..",II.'..,.'...III..'.,.'..'.,III.'.."'1"""'11""""""""'11"'11"'11""""""11'1"'11111""11111111111"'1""1'1 <br /> <br />BUILDER <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 />ELECTRICIAN <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 />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />y y y / ./I //r ,.", <br /> <br />I <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />III1III111IIIII1111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />License # <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 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 wi 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111I1111111111111111111I <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 cqntractor) 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />