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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />r-ax-o I-'-IOU-UUL I <br /> <br />Date Received I D ~ d-I- 0 to <br />Owner's Name '"De. ~O-d McJ--.ouh:-h., <br />Qwne,',Add"," L~~"-t G,,,-'-<-- ~,.<oJ <br />Fee Simple Titleholder Name <br />Fee Simple 11l1o.old" Add.... ~ <br />JOB ADDRESS llt\Jl I <br /> <br /> <br />I C:"''"YV"'\~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />Zf>h\.-\(h\\6 <br />I PARCEL 10#1 <br /> <br />B <br />D <br />D <br />~(VY\.e.d plct.:':>-h'c. <br /> <br />SQ FOOTAGE I <br /> <br />1=L. :::>:54' <br /> <br />I <br /> <br />~ '&vcl <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN [S(] MOVE D <br /> <br />DEMOLISH <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />Ilsil <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D OTHER <br />D STEEL D OTHER I I <br />16r\-+e...--.s - ~ mC>-Y\-kc\ ~ ~ (.JJ<Lt( -St ~I <br />I HEIGHT I I <br /> <br />WORK PROPOSED <br /> <br />hi61-l-- <br /> <br />BUILDiNG SIZE <br /> <br />11111111...1111111111..11...1.11111.1.1.1.......111...111......111....1111........'....1111..11.1111........."..,........11..1111....1111.....11. <br /> <br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />ctJ ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />'1111.,,11"."11"'1111'1111".1"1."...111"1."111""'111'1'1,,'..'.'111,1"'1111.."111'111"'1111"'..1'...'..1.'1.11.1.111111'11..,'."'111 <br /> <br />BUILDER I <br />SIGNATURE <br /> <br />Address I LIcense # <br /> <br />~:-i.\';~~AN~~VL- 52,'" I ;~:~~11~i'~~("1 <br /> <br />Address 'P.O. bui ~<.o~ ZphL.1(h,lL:s,'ft... 3?Qft-Q&:';L. <br /> <br />I ~~:~~~~ I <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />LIcense # <br /> <br />J L"N C.- . <br />'y IN I <br />I EC.-t?cO \ ~ ~~ <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />MECHANICAL <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 />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 />111111111111111111111111111111' 11111111111' 1111111111111' 111111111111' 111111111111111111111111111111111111111111111111111111111111' 1'1111111111111 <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 wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislonsllarge projects <br />COMMERCIAL Attach (3) 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 onslte, Construction Plans, Stormwater Plans wI 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 1I111111111I11111111I1111I1111I1II i 11III111 t I1III1 t II <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 Attomey (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 />