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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Name <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Address I <br /> <br />10330 <br />I <br /> <br />JOB ADDRESS <br /> <br />\ L.-J\A S+ <br /> <br />Z-ef\A~vl-tI'lIs ~( <br /> <br />PARCEL 10#102- - L(o - Ll -(fJOD -63,/00 - 0010 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />LOT # <br /> <br />I <br /> <br />o NEW CONSTR 0 ADD/ALT 0 <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 <br /> <br />DESCRIPTION OF WORK I f2--e rOb ~ ~/ a f ~tl4, (f ('Jr (~lt'J <br />. v <br /> <br />BUILDING SIZE I ' I sa FOOTAGE I 2 1tJ () I HEIGHT I <br /> <br />I., . . I . I . . . . . I . . . . I I I I '.' I I I . I . , I . I I I I . . I I I I I . . . I I I . . , . I . . . I I I . . . : . . I . . I I I . . . I I I I . . . I I . . . . I I . . . . I . I I . ... . . . I I I I I I I I . . . . . . I I I I I . . . . . . . . . . . . . . . . . . . . . . . <br /> <br />D BUILDING 1$ 0 2JS: 0 v I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL ~ I <br /> <br />D GAS ROOFING D <br />FINISHED FLOOR ELEVATION I <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />""1"""1""111"1"1""""1'1""'11'1111""'1'11...1..111...,1.,..,11'1...'...'11'11.,."...."11.'"11""""'1"'1"""'11""11111" <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />I J{ C--tt-Q)(Or..~qk ~It Vr <br />I Y / N I FEE CURRENT I Y r N I <br /> <br />License # I(C(O J7 f r 7 <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 />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 />11I111111111111 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 />11111I1111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111II111111111111111111I111111111111111I <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 AfC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />