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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />* " ~ 30 Fax-813-780-0021 <br /> <br />c/j~ <br />{ IL- <br />I <br /> <br />Date Received <br /> <br /> <br />3' 7 <br />Owner Phone Number 1~lo ~~6 -7'744 <br /> <br />Owner Phone Number I8l~' 8 ~)6 . 77# <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name 1 <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br /> <br />Fee Simple Titleholder Address <br /> <br />~& fJ2.?Y ~' " bluFf Li2. <br />lS'i\~,rucb l!c~J ..."",,!M<1&JI,;J:M <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />ISZI NEWCONSTR D ADDIALT 0 SIGN D MOVE 0 <br />E::SI INSTALL D REPAIR <br />PROPOSED USE ~ SFR D COMM 0 <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 <br /> <br />"SC~,",,"O'WORK [llmU (;)~. '7ff0n <br /> <br />BUILDING SIZE I SQ FOOTAG I <br /> <br />SUBDIVISION <br /> <br />:'lOrD <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />,J;8J <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 W,R,E.C, <br />~ PLUMBING l$qC[) 6 -- I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS 1 I FLOOD ZONE AREA DYES ONO <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />l.Y.!...!:U <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />I ~ -:1 J OOM"~ <br /> <br />. _ _ REGISTERED <br /> <br />IPldQ~ ffru.{") /Jj qJt7l1q/-Jil/ ~lf&(~ <br /> <br />YIN <br /> <br />FEE CURRENT <br /> <br />~ <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction, <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Storm water Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects <br />Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms, R-Q-W Permit for new construction, <br />Minimum ten (10) working days after submittal date, Required onsite, Construction Plans, Storm water Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster, Site Work Permit for all new projects, All commercial requirements must meet compiiance <br />Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW construction, <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 required. (A/C upgrades over $5000) <br /> <br />Agent (for the contractor) or Power of Attorney (for the owner) wouid 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 />Driveways-Not over Counter if on public roadways"needs ROW <br />