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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 R~ceived .. <br /> <br /> <br />-B-c>~ <br />041L 12uU~€S: <br /> <br />,Owner's Name <br /> <br />Owner's Address I <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I ~ 17 t) !l.. <br /> <br />~ 3-t I J.=c;f. OAK- "Eu0 ~I(L . <br /> <br />I I PARCEL 10#1 <br /> <br />r\7i NEW CONSTR rv-r ADD/ALT D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK 5ZI FRAME D <br /> <br />DESCRIPTION OF WORK I (..0112.,106.- 0;:= S-ro~~ <br /> <br />BUILDING SIZE 1:1u llll) 0)( 1;2..1 SQ FOOTAGE I~ ~:::Vr I <br /> <br />.,11..,11....111..11,..,11.."..."...1111.....,11..,11..111..."....,11.....11..11,...1,.......1...1..'........'.1,,1.....,.11111111111111111111. <br /> <br />1$ I <br />1$3S0~UNrr AMPS <br />1$ I <br />1$ I <br /> <br />D GAS D ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />HEIGHT <br /> <br />le' <br /> <br />D <br />IYf <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />D <br /> <br />PLUMBING <br /> <br />DYES <br /> <br />DNO <br /> <br /> <br />D <br /> <br />MECHANICAL <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Add,... ~ <br />ELECTRICIAN l' .;; /:;2 _ I <br />SIGNATURE ._ ~ <br />Address I ~ ~OYL. ~$'54 P- I <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />OD"-.J WA-E1Ja~L. 11\.JC- <br />I Y / N I FEE CURRENT I Y / N I <br /> <br />License # rECJ 3DD t ;).f!;7 <br /> <br />ptUMBER <br />SIGNATURE <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 /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N I. <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />11I111111111111 11111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111I11111111111111111111 <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 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 />I11I1I11I111111111I11111111111111111111111111111I11111I11I11111111111111111111I111111I111111II11111II1I1I1111111II11I1I11111111111111I11I111111111 <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />