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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 />Dale Received <br /> <br /> <br />-If'/} ~rS <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fe. Simpl. Till.holder Namel ~ z... 3 3 <br /> <br /> <br />Fee Simple Titlehold.r Address I <br /> <br />v~tt~ ~O <br /> <br />JOB ADDRESS <br /> <br />~ 1. '33 D <br /> I <br />B NEW CONSTR ~ ADD/AL T D <br />INSTALL REPAIR <br />D SFR D COMM ell' <br />D BLOCK D FRAME D <br />(.N\~c..\ <to ~.. .lOV'CC..Sh'L IUcl.tu ..t ~,. <br /> <br /> <br />LOT# <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />,..otl.uti.,\ <br />OTHER I ~iu. S~.",k.lu <br /> <br />C.."t~1 "_11M. '-ctflow.. . <br /> <br />DESCRIPTION OF WORK <br /> <br />OTHER If," <br />STEEL [tJ <br /> <br />ell.4t\.t.f . <br /> <br />SQ FOOTAGE I <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />~ <br /> <br />BUILDING <br /> <br />1$ <br /> <br />D ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />DGAS D <br />FINISHED FLOOR ELEVATIONS I <br />- 'T- 'f - <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGV <br /> <br />o <br /> <br />w.R.E.C. <br /> <br />VALUATION OF TOTAL CONSTRUCTION 3'1CZ (;:> .012) <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br />SPECIAL TV D OTHER <br />FLOOD ZONE AREA DVES DNO <br /> 1 T~ <br />COMPANY <br />REGISTERED VI N FEE CURRENT I V/N I <br /> License # <br />COMPANY <br />REGISTERED V/ N FEE CURRENT ~ <br /> License # <br />COMPANY <br />REGISTERED VI N FEE CURRENT ~ <br /> License # <br />COMPANY <br />REGISTERED V/N FEE CURRENT ~ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNA TURE <br /> <br />Address I ~Ic) <br /> <br />I <br /> <br />.t)~t~;o~ floc.c 'f ~ H U6Jt <br /> <br />COMPANY <br />REGISTERED <br /> <br />(.01 <br />V/ N <br /> <br />License # I <br /> <br />~iK P('(!)+~l.+"()1) <br />FEE CURRENT V / N <br /> <br />License # 10"" f'lt>OOfl'lfS <br /> <br /> <br />AU <br /> <br />RESIDENTIAL <br /> <br />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 w/ Silt Fence installed. <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />Attach (3) complete sets of Building Plans plus a L~e 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 />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 $2600, a Nolice of Commencement is required. (A/C upgrades over $60001 <br /> <br />Agent (for the contractor) or Power of Attomey (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 NC Fences (Plol/Survey/Footage) <br />Driveways-Not over Counter ~ on public roadways. .needs ROW <br /> <br /> <br />---------- <br /> <br />.----. <br />