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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />I Q^-UI.... ........ ........-. <br /> <br />Date Received <br /> <br />1- 30 ~ D <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />~ <br /> <br />Owner's Name GC)llcN Pi'l'~M / !lJr.:~;.htJiD JV1ALI/( <br /> <br /> <br />Owner's Address I <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />3,LfJS E,I",,vd 8(1/0 <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />o <br />o <br /> <br />PARCELID#163-~<O-OI-()D\O~bIo4'DO -DC6\ <br />IOBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />c;3 <br /> <br />COMM <br />FRAME <br /> <br />B <br /> <br />PROPOSED USE 0 <br /> <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I ~ Q.-.\ ~~ o.u.e.- A-o ~ i e.. - fuo_9..,~_:0i::it-R, ~\5t \ n..:; <br /> <br />BUILDING SIZE I sa FOOTAGE I HEIGHT I <br />TfT'TT111111111111111111111' I , I11I1111 , III , III , III t 1111I1111111 · 111111111111111111 , III ; 11111 · , 11111 . 1111111111 , II . 11111I11111111111111111111111111 <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />o BUILDING 1$ I <br /> <br />~ ELECTRICAL 1$156D"~ I <br />o PLUMBING 1$ I <br /> <br />o MECHANICAL 1$ I <br /> <br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />11111111111111111111111111111111111111111111 ! 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />::::~~RE I I ;:'o~:;:= I Y I N FEE ""'RENT Y I N I <br /> <br /> <br />Address I License # I <br /> <br />ELECTRICIAN I (]Jf .it t ~ <br />SIGNATURE. ~ - <br /> <br />Address I c; 4 lILt (. .', I" A'.( ,( A ,,1.<. . -2 ~ ,-I; ( I s <br /> <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br />ZOD <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I License # <br /> <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 onslle, Construction Plans, Stormwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislons/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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />11...1.1111111.1.11......11111.1111....1.111..11111111...11..111....111...1111...111.........11......11'....11111....111111111..,111.111111....111 <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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />