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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />I ....., .... ,- . -- - <br /> <br />. <br /> <br /> <br /> <br />-30 -07 <br />l-:-jo/Y1~ il!{J~ <br />Owner's Address I -ciq t. 5"' L j'1fT11:::'I1't"1 {.r <br />FQe Simple Titleholder Namel <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />l,-1ftj <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br />~6~Z-- <br /> <br />LOT # <br /> <br />18.\0 <br /> <br />/lfflaNt-/fT"' tlJlUt <br /> <br />I PARCEL ID#Ic;>t-\ ,~(o.~, - 0050 - COCDD - d-.\OD <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />rvf ADD/ALT 0 SIGN 0 MOVE 0 <br />t=l REPAIR <br />D COMM 0 <br />D FRAME 0 <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK 1.3 ~ I f II; I, S-(() tLfr0e ,1+-t:r9 <br /> <br />BUILDING SIZE I I sa FOOTAGE I ~-O 0 I HEIGHT I JA! / Ie '1 I <br />111111111111111111111111111'11"'1111'11'111111111111111111111111111111111111111111111;11'1'111111111111111111111'11111111111111111111111111111111 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I JIO~6 <br /> <br />/ bJtf1C. If:.' <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />o BUILDING 1$ <br />o ELECTRICAL 1$ <br />o PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR,EL.EVATIONS I <br /> <br />AMP SERVICE c=J <br />, I I -e~ ~... ~ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY 0 OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />License # <br /> <br />I111111111111111111111111I111111111I1111I1111I1111111111I1111111111111111I1111111111111111I111111111I11111111111111111111111111111 <br /> <br />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 w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />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 wi Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans, <br />""PROPERTY SURVEY required for all NEW construction. <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />0D,- <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 />COMPANY <br />REGISTERED <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />f.It(t IJC {)~I#t:7l <br />-I . Y / N I FEE CURRENT <br /> <br />License # I <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <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 />'...,1111111.,11111.,..111111111............,11..............,.................................................................................... <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 />