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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />r-ax-trij-ltlU-UULI <br /> <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />- Fl 16 <br />llogq '-1: . ~btlLl Qd S,^-\ -ie.. 6 '~ 10 I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br /> <br />Fee Simple Titleholder Address <br /> <br />Owner Phone Number <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />LOT # I ~ <br /> <br />.pARCEL ID#l28 -2f.n -21 -603 O-()OOOO '0 ~~O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN 0 MOVE D <br /> <br />[3'" OTHER <br />D STEEL <br /> <br />B <br />o <br />o <br /> <br />DESCRIPTION OF WORK LPO-(l \Y\6dJJ ~+ ~ <br /> <br />BUILDING SIZE I \2- X ?:,q ISQ FOOTAGE I L( Ie g I HEIGHT I I <br /> <br />-".'-'fTTTTTTTTf-rr",.."",. ,-." "II"""""" II'" 1"""""""""""""""""""""'1"""""""""'" I"""'" I""""""'" , <br /> <br />D BUILDING 1$ I ~OOO . G 0 I VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL 1$ Lj(:X). c 0 I <br /> <br />D PLUMBING 1$ 250," 0 I <br /> <br />D MECHANICAL 1$ 5"OD, 00 I <br /> <br />D GAS D ROOFING 0 <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />PROPOSED LISE <br />TYPE OF CONSTRUCTION <br /> <br />DEMOLISH <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />D <br />./ <br />V~'U <br /> <br />W.R.E.C. <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATiON <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />~~fl'I"'II'I"llllf"III'I""IIII"I"I'III"lllf'"111111"I'I"'IIII""I'I",II'III""llllti"""f'"I""IIII"I'IIIIII'II~III' <br /> <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address '-Ie. <br /> <br />~~;~~~~~".~~ <br /> <br /> <br />Address ~ ~__. <br /> <br /> <br />:~:A~~~E ~~-- I <br /> <br /> <br />Address _ _ <br /> <br /> <br />~1~~~~I~:LI~~~, I <br /> <br /> <br />Address; i <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address; I <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />113t&-f~1eJ,1 !:"'~ '\ 10" <br /> <br /> <br />License # I <br /> <br />I~qul l-Jecl/,tJ2 <br />Y N FEE CURRENT N <br />License # I <br />IVI <br /> <br /> <br />License # <br /> <br /> <br />FEE CURRENT <br /> <br /> <br />ACE; <br /> <br />License # <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />1111I11I111I1111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111III11111111111111111111111111111111111 <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 onsile, Construction Plans, Stormwater Plans w/ Sill Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projec(s <br />COMMERCIA.L 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/ Slit Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projec(s. All commercial requirements must meet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW constructlon".".y;.:. .. <br />1I111111111111111111111111111111111111111111111 /111111111111111111 i 111111 /I /II /II /111111111 i 1111111111111111 filii i II i II III i i 111111 i 111111 i 11II111I <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 (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways"needs ROW <br />