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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />raX-lll"-/llU-UU': I <br /> <br /> <br /> <br /> <br />Date Received I D ~(,.lt- O<.p <br /> <br />Owner's Name L <br />Owner's Address 3fl 00 4 Tr ~ /1) '5 <br />Fee Simple Titleholder Namel <br /> <br />fJlIP- . <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 3g60'-! Jre/IJ~ <br />I R1lhq V/!/~(-> <br />El <br />D <br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME <br />DESCRIPTION OF WORK I (Ke - SA~iY7J ~ <br />BUILDING SIZE I lIOo ISQ FOOTAGE I 1\ Joo <br />. <br />1'...1.1.,...11",1111.......1111111.1....11......1111..'1.11..........111111....111111....11....111111......IIIIIII'p.....I.I.IIIIIII.IIIIIII.I.I <br /> <br />JOB ADDRESS <br /> <br />f)v~- <br /> <br />I PARCEL ID#I <br /> <br />B <br />D <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />35- 2.5- 2-1 - (jJ<;; A - OooDO- / '/do <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br /> <br />D <br />D <br />o <br /> <br />PROPOSED USE <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />0 MECHANICAL 1$ <br />D GAS rsn <br />FINISHED FLOOR ELEVATIONS I <br /> <br />750 <br /> <br />HEIGHT 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 />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />"'",lllllnlllllll"IIIII,I'II',I'IIIIIIIIIII"IIII""'111""'1""""1'11'111111,..."""..",'1111111",11.""'11111111"'.'....1"'...'1 <br /> <br />BU,LDER ! 0 . ~~ <br />SIGNATURE . f~ __ _y <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />Address <br /> <br />I ~ FS~Rtf< <br /> <br /> <br />License # I <br /> <br />Y/N <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 /> <br />11111111' 111I11 111111111111111111111111111111111111111' 11111111111111111' 111'111111' 1111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Pennit for new construction, <br />Minimum ten (10) working days after submittal date. ReqUired onslle, Construction Plans, Stonnwater Plans w/ Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Penn It for subdivisions/large projects <br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Pennlt for new construction. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Penn It 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 />111I , 1111 , 1I1111111111111111111 , 11111111111111111111111111111111111111111111111111111111III i 111111I11I111 i 11I1111 i I1I1III11IIII i 111111111111111111 <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 NC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />