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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit AppliCatiOn <br />,r/3uilding Department <br />flazw Itrm: fSerl1 <br />Phone Contact for Permitting <br /> <br />I ~^.v..... t....... ......_. <br /> <br />813-780-0020 <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />~Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Name <br /> <br />6a me.- <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />'Fi- 339-1C0 LOT# I 'It <br /> <br /> <br />PARCEL ID#IOQ- ;).{;- ;:J.!-6/90-()(j{)()!j-CtfrD/ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISiON <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />D NEW CONSTR CJ ADDIAL T D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL <br /> <br />DESCRIPTION OF WORK I &r~e.fl rOD rI1 tu1 d (D()~~ <br /> <br />I / tfX) '-f 1 I SQ FOOTAGE I /10 tP I HEIGHT I <br /> <br />1'.......,...".,........."..,111................................,.................................,..........,11'../...................,.,... <br /> <br />D BUILDING 1$ 6 o3Q ~ VALUATION OF TOTAL CONSTRUCTION ~;c. ./ <br />D ELECTRICAL 1$ AMP SERVICE ~ PROGRESS ENERGY D <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D ROOFING D SPECIALTY D <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA <br /> <br />,.'.,1"1,'11.....".."1"1'..............,1",,,1,1...'.II'IIIIIIIIIIIIIII~...PIIIIIII""I....,IIII'..,..111111111""1111111111111111111111 <br /> <br />.U'LDER o/lb~PANY I ~r'5 Alwmll1f!41Ui:f1rr I <br />SIGNATURE REGISTERED Y N I FEE CURRENT N <br />License # Ic-& o;<~()77 I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />I <br />o <br />slah <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />OTHER <br />DYES ~NO <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <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 <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />111I11111111111111111111111111111111111111111111111111II " 1111111111111111111111111 , II " 11111111111111111111111111111111111111111111111111111111II <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 onsite, Construction Plans, Stormwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlsionsllarge 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 wI Slit 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 />I111 " 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 (Plol/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />