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<br />,613-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />~?>D~ <br /> <br />Date Received <br /> <br /> <br /> <br />Owner's Name ((OS~ 3~O-uo~'t.- <br /> <br /> <br />Owner'sAddress 13~'.:Siq 'i.~(:.A \'-1f\0S t::>VL 2.\-\ '~l- <br /> <br /> <br />Fee Simple Titleholder Namel ' <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />5~~\ ~ ct:...X.Al411>\us. D Q. <br />. <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />Dl2.t (:'\Lo.)(5>O D <br /> <br />I <br />B <br />D <br />D <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />PARCEL ID#I <Y2 -L.b -2\-0'1-4-0-66000 - 01100 <br /> <br />E3 <br />D <br />D <br />DESCRIPTION OF WORK I '5c.~'l:.~i-J l-~ PC>~\L\A. <br />BUILDING SIZE SQ FOOTAGE I \200 HEIGHT I I <br />S"'" ~~,~~~"""" 'i~"'~ ~~ ~:;;"..,.." i"'" ~~:~~~:~~ '~~ ~~~~ :~:-;;'~;;;,;::"""""""""""""""""""" , <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~NO <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />BUILDER I <br />SIGNATURE <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />D <br />D <br />D <br /> <br />OTHER 1St \~_'<-e(0 l ~ <br />STEEL D OTHER I <br /> <br />~Dli2TC~ <br /> <br />D PROGRESS ENERGY D <br />\\ ~ 6.. .A.MT -e \A- \ \A. ' \.S, <br />~ 200, \-\e\fe~ - \,..)':~dlt t?- <br />VALUATION OF MECHANICAL INSTALLATiON -rcSlA\ \\> ~~O" 00 <br /> <br />AMP SERVICE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <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 />a 0-<1-c- ~ <br /> <br />52. -5~ <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> <br />W.R.E.C, <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />\-\cMe. OLU~e\Jl- <br />I Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />Address S DO-- License # <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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/ Slit 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 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 /> <br />DI~~ti~~~': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> <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 />ReroofEI Sewers Service Upgrades A1C Fences (PloUSurVey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />