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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 />,uQ,{fI q /..or ~ <br />13~ech <br /> <br /> <br />Owner Phone Number <6'/3 - 3;).3 -- L,t5<? <br />Owner Phone Number:. ~ I 3 -"ii/,d';{ - 'N,07 <br />Owner Phone Number . <br /> <br />Owner's Name <br /> <br />Owner's Address I Sfo Ie:< <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />IS~/~ <br />I <br /> <br />f> e.e cJ, <br /> <br />5~ <br /> <br />LOT # <br /> <br />I <br /> <br />[d NEW CONSTR E3 <br />~ INSTALL <br />PROPOSED USE c:1P SFR D . <br />TYPE OF CONSTRUCTION 0 BLOCK D <br /> <br />DESCRIPTION OF WORK I Q~1aLR <.. ') fv.p( / 2 -F 2 () <br /> <br />BUILDING SIZE I / ~X Ol.....Q I SQ FOOTAGE I .Q.;t 0 HEIGHT / / fl. I <br /> <br />,.,1,.,11,....1....,11..."..11,..'"...,.......,11.111,.....,.,1,..."...........11,..11,..,11,....,1.'1,.......,"',.....,1111,.........,...11.',1" <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />o <br />o <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />OTHER <br />STEEL <br /> <br />~ BUILDING 1$ 5i DaD .. 0-.:9 I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS 0 ROOFING D <br />FINISHED FLOOR ELEVATIONS <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />4 <br /> <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />COMPANY <br />~EGISTERED <br /> <br />I(!,~~/;>~:rt!~(€-, ~r~;& <br /> <br /> <br />License # I <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />PLUMBER <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 <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />1I1111111111111 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 w/ 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 />1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 j <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />