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<br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application {( <br />Building Department ~. 6 \ 'I: ( <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name (lilt: j7~fL tf~rE <br />Owner'sAddress I :31Ji1 P{~Y511Itlt pI/I/r <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br />5'1//f{ AJ 4tl~V~ <br />t/[f}{.{/t/#i/t) <br /> <br />JOB ADDRESS <br /> <br />I PARCEL ID#I <br />B ADD/ALT D <br />REPAIR <br />D COMM D <br />~ FRAME D <br /> <br />SUBDIVISION <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK 1/?-(..-;2 P P ~ <br /> <br />5000 I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />LOT # <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />3e?-CJ <br /> <br />HEIGHT I 1- .5P~/ <br /> <br />SQ FOOTAGE I <br /> <br />BUILDING SIZE <br /> <br />,'".1111111....1.....1...11.......111".,111...1111,.11...11...11...'.........'...11.'..11....111.....11.1111.......111.....111111.'11111111111111 <br /> <br />D BUILDING 1$ I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />0 MECHANICAL 1$ I <br />D GAS m ROOFING D <br />FINISHED FLOOR ELEVATIONS I I I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />Address <br /> <br />111111111111111 111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111I1111111111111111 <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 subdivisionsfJarge 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 (1 O) 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 />111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111I1I111111111111111111111111111111111 <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 />BUILDER <br />SIGNATURE <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />DNO <br /> <br />/f,/(//Af-lA/'/ /Z1JCI/7#'? <br />1&/ N I FEE CURRENT I Y / N I <br /> <br />License # I .t' c: c /-.:- Z b / b '" <br /> <br />Y / N FEE CURRENT <br /> License # <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 />Y/N <br /> <br />Y/N <br /> <br />Y/N <br />