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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 />Lu.5l\~ =r"'''\CJ\\1\tr\\" \-\-o~)IN~ <br /> <br /> <br />\.;IJ ,c. <br />\ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address "2..'2>~J.\. ~~\Nb ~~~~<::;. W~ <br />Fee Simple Titleholder Namel ~ <br /> <br />Fee Simple Titleholder Address <br /> <br />'S~J <br />1.0 J \ 2. 3)1\1 P--Jl <br /> <br />JOB ADDRESS <br /> <br />ZH: <br />, <br /> <br />PARCEL ID#I <br /> <br />LOT # <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />02- ~ -""2-\ -0010- <y~~~- ~OO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />o <br />o <br /> <br />D <br />D <br />D <br /> <br />OTHER I Sit't. u\ClP ~. <br />STEEL D OTHER I <br /> <br />Sl~ iNClU- <br />I SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />I ., I I I I . . . I I I , . , , , . . . I ~ r . . I I , , I I . . I I I . . . . I I I . . . I I I . , . I I . . I . . . . I , I . . I I I . . . . I . . . . . I I I , . I I I . . . I I I . . . I . I . .. . I . I I I I I I I . . . . . . . I I I . . . . . . I I I I I I I I I I I I I . I . I I I <br /> <br />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C. <br />0 PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />''12'1 \1l ~ L<Jl\j 'S'lL\).(.-t\.oA 1'4:N ~ <br />I' YI N 1 FEE CURRENT I Y/N I <br /> <br />License # I <br /> <br />11.. \Lt~ I r{'--~~flV\M I <br />Address I ~q.\~ SQ..,-~~ l 2YQ~lLl-\l'-k<) <br />ELECTRICIAN I <br />SIGNATURE . <br />Address I <br /> <br />COMPANY <br />REGISTERED <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 />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 />111I11111I11111 11111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111 <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 />1111111111111111111I1111111111I11111I1111II1111I11111II111III111I1111I1111111II1111I1111111111III111111II1II1IIIIIIIIIIIIIIIIIIIIlIIIIIIIIIIIIIIII <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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />