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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br /> <br /> <br />1f-8()f3 <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />Bf3/fS/ <br /> <br />to 71f mJ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />@ <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />"""""""'11"""""'1"""""""""""'"'1"""""1""""""'1'1"""""1""""""""....,."",..."."",.""""."., <br /> <br />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br />0 PLUMBING 1$ I <br />ITiII MECHANICAL 1$ t.f 7 ()O ~o I VALUATION OF MECHANICAL INSTALLATION <br />0 GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111"'1"""1111111"11111'111'1111"""'1111111'....",.,1111.11""111"111"""..111...'.111..'..'.""..,....'....111'11..'.'1"..11'111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED Y/N FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED I Y/ N FEE CURRENT Y/N <br /> License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />MECHANICA <br />SIGNATURE <br /> <br /> <br /> <br />License # <br /> <br /> <br />FEE CURRENT <br /> <br />License # ~I go! 7' ~"kZ <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />1111111111I111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />I1111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111II1111111111111111111111111111111111 <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 />