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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 />Owner's Name <br /> <br /> <br />.c.HIZIS CooJ;e <br />Phone Contact for Permitting <br /> <br /> <br />Owner Phone Number B 3 ~ 783 . ~/8 <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Address I <br /> <br />17050 <br />I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />B <br />D <br /> <br />C:::A-1J BLvd,.. 7e.phyr ~)\S, FL, '$15'1' <br />I PARCEL ID#I <br /> <br />B <br />o <br />D BLOCK 0 FRAME D STEEL D OTHER I I <br />r-=-= I~~ . . ~~ I <br />L~f.l . D~l"ft()1J ~ e.)t:~+/~{,. 2Nd PIOOIl. ~ 5j1~ CMH UJ6, <br />I sa FOOTAGE I I HEIGHT I . . I JJfJ.3. <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />ADDf1([T) <br />RE~ <br />COMM <br /> <br />D <br />D <br /> <br />OTHER <br /> <br />H eol Utl.... <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />"11.1111..'.111..111.........11.111...1111.........11.'...11....11.....11.....11.'...1111..111.......1111.'....1.......11'1........................ <br /> <br />D BUILDING 1$ I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS D ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY .. 0 <br /> <br />;~oeg \ <br />/J <br /> <br />---"--' <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATI <br /> <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />Address <br /> <br /> <br />I SWJa$ ~~~~, JM. <br />I Y/ N I FEE CURRENT I Y/N I <br /> <br />License # I c....&c. 057/ ~ 3 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <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 />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />II1111IIII11I11111111111111111111111111111111111111111I111I1I1IIII111111111111111111111111111111111111111111II11II11111111111111111111111111111111 <br /> <br />Address <br /> <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 />11111111II111111II111I11111I111II111111111111111111111111111111111111111111111111111111111111111111111111II111111111111I111111111111I1II1111111111 <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 Ale Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br /> <br />:" <br /> <br />'.( <br />