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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit AppliCatiOn <br />Building Department <br /> <br />I QA-U Iv-' VV v......... <br /> <br />Date Received <br /> <br />ld- 5 D~ <br />Owner's Name t::.C/ r d M a ~e Owner Phone Number <br />OWn.Mdd,... I 35D~~~~~ ~~J1fftr/~ T"PhonoNwnbo,1 <br /> <br />Fee Simple Titleholder Namel_ _'.!JtJ.ri ft!a7.1LLe..." _ Owner Phone Number I <br /> <br />t~ <br />(. (5 rc <br />PARCEL 10#1 J.1-- /J.fP- ;J/-t):j 7(}-tl)C/J-d.-cf1d <br />(OBTAINED FROM PROPERTY TAX NOTICEI <br />D SIGN D MOVE D DEMOLISH <br /> <br />o <br />D <br /> <br /> <br /> <br /> <br />LOT # <br /> <br />I02Lf71 <br />I <br /> <br />JOB ADDRESS <br /> <br />I Etnt?ftl-/dPo, rJ~RV I <br /> <br />D NEW CONSTR rL9 <br />D INSTALL D <br />PROPOSED USE 0 SFR 0 <br />TYPE OF CONSTRUCTION 0 BLOCK 0 <br /> <br />DESCRIPTION OF WORK I SU./!. ~n (" O() yY]. <br /> <br />~~:~?,'~~.~~..., ,I,.!. ~.~~ ~"",.,',!,'" ,~~ ~~~~~~!. /?t}, t..,."",1,." ,~~I~~~,!"""..""""",.. ,I"""""""".."... <br /> <br />!:Xl BUILDING 1$ :21 t;JO. (JD I VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ I <br />1$ I <br />1$ I <br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~NO <br /> <br />111'11" III" II:" '" ~ t" II"'" -;""'~" I'll'" III1 'I" '11'11 \' ~z..: ,~tS PI' 'II' 'I" II" '11'111 1'1'" II' 'II" II' III '11"1111111' III t III 'I <br /> <br />BUILDER · COMPANY I quY7~ I <br />SIGNATURE REGISTERED Y I N FEE CURRENT Y I N <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I aJtl..#t/'1 ~ <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br />40j0 \[)1LJ. <br /> <br />PROGRESS ENERGY <br /> <br />~ W.R.E.C, <br /> <br />~\'6/ <br /> <br />D <br />D <br />D <br /> <br />PLUMBING <br /> <br />~ cv... \L <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br /> <br /> License # <br />Y IN FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <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 />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />111111111111111 1111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111II11111111111111111 <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 subdivlsionsllarge 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111 <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 />