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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 R&ceived - <br /> <br /> <br />51-- ~icv- s <br />V e ~ f" Ill! kr 5. h..w <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I ~ 3llq <br />I <br /> <br />t \ ~ Sf- <br /> <br />'2- h .'/ [s ~ \ ]'3:)'12- <br /> <br />PARCELlD#llJ - L (p - L I - Oaf () -/7/ 00 - 0 100 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br /> <br />SUBDIVISION <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I Nrov-F C~ uv-c.. L... -tJ PctYI".s h C-t/^..k'r \A) l'-tt--. at 5-0 '(p-~v /;'wJafJ1/t'--{. <br /> <br />~~~~~.I~~, ~~~~" 1.1""'"...". , "" , "" ,I" , "~~ .~~~~~~~! (. .?P.. ,~~"".I.. '" ~~I~~,~.!...""".,..,.,."" .I.."'.""'."".""'. <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />D BUILDING <br /> <br />1$ :~ &"J 7U D (c) vi <br /> <br />r <br /> <br />1$ I <br />1$ I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL <br /> <br />D PLUMBING <br /> <br />D MECHANICAL <br /> <br />D GAS <br />FINISHED FLOOR ELEVATI <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />W.R.E.C. <br /> <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING D <br /> <br />SPECIALTY D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />1'...111'."'11111....."'."'.,11'..1111'1111...11111"1111"'111111'1""'11111111'111111111'1111111'1'1""1'111"1"'11"'111"1111"""'1111 <br /> <br />BUILDER <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 />Y/N FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />-------- <br /> <br />License # I <br /> <br />COMPANY 15Uv t/rs)( ti: ~tf....A;'" ~/7 kf <br />REGISTERED I Y / N I FEE CURRENT I Y / N <br /> <br />License # I CC [0 J-} is-- 7 <br /> <br />Address <br /> <br />OTHER k~ <br />SIGNATURE " <br />Address 1.33 0 l o5K- :;: z. <br /> <br />P~1}0X IllY <br /> <br />111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111 <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. (Ale 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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />