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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />I ~ /~jC'~5 <br />Owner'sAddress I ~~I/ KeX5eu)Oc:JJ} t:-r <br />Fee Simple Titleholder Namel <br /> <br />Owner's Name <br /> <br />Fee Simple Titleholder Address I <br /> <br />I $~4J e:- <br />rnJ~(~c\ <br />@ <br />PROPOSED USE ~ <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK IC~JU /)0 -- (~j;/l/.Lh(-L/ ifi=~tENE/1/r -- ./f///\/K <br /> <br />BUILDING SIZE I sa FOOTAGE I HEIGHT I <br /> <br />..111..111...11...11...111.111.11.........1111...'....11..111...11....1.....111...111..,....11..............111...'..'11..'..11.."'..............11 <br /> <br />1$ /~1't. 9s1 <br /> <br />. <br /> <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING D <br /> <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />PARCELlD#1 02--- 2/p - t,,/ -Ol( 6 ../ QOC(;D-OOUJ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN 0 MOVE D DEMOLISH <br /> <br />D <br />D <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />'ikmenu~ <br />I Y I N I FEE CURRENT <br />License # I <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />Address <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 License # <br /> <br />11II111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111 <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 />11111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111I11111 <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 AlC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />