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<br />81:3-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br />111111111111 <br /> <br />Owner's Name <br /> <br /> <br />I' C~ <br />/.kk/1 Ti bb,s <br />I J j(pJ 7 /)()rff, <br /> <br /> <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Ave. <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />813-1Se..5314 <br /> <br />I <br />I <br />I/-s 131~ f <br />I <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />3 if, ~ 7 <br /> <br />norli> <br />p ~ r'/( <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />D <br />D <br />D <br />ai 91Y1:t1t d <br />- <br /> <br />SQ FOOTAGE I / S- () J/; I <br /> <br />LOT # <br /> <br />PARCELlD#1 tJoJ- cJ4-tJ/-()()Ij()-OOIt{)r)-())CO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />OLk <br /> <br />DESCRIPTION OF WORK <br /> <br />~ <br />D <br />D <br />I <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />OTHER <br />STEEL <br /> <br />kve/ <br /> <br />I <br />D <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />fV06o/ <br />I <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />....'....'111........11...111..11.......111........111....111..................,...........1111...111.11.............'.11......................... <br /> <br />[Xl BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I, ?()O. 00 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />[) <br />. :-sr, \\ 0_ rP. <br />O. L...,..:7 . uJ' ~v--~ <br />~ \,D--~ ttf'" <br />~ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />cSk~ ~ Aq~^-f <br /> <br />v <br /> <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br /> w/Jefl!"/).. <br /> License # <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 /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />f. O. (jOY /~S-t:L <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />OTHER <br />SIGNATURE: <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111111111111111 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 onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsile, 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 />111111111111I111111111111111111111111111111111111111111111111111111111111111111111111I11I1111111111111111111I1111111111I1111111111111I11II11111111 <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />