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<br />I I <br />81:1-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />7;>, <br />7';) '7 <br /> <br />.-, 4 fpx-813-780-0021 <br />0(' '5 -COG:> {'7 - You'is <br />34r - ? 5'~'t <br /> <br />Date R/ilceived <br /> <br /> <br />J../~.:3 1 <br /> <br />:;(OJH ~ <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />l..;?,S1 <br /> <br />;;; 0 rl-f ~ <br /> <br />LOT # <br /> <br />I <br /> <br /> <br />E3 ADO/ALT D <br />REPAIR <br /> <br />D COMM D <br /> <br />D FRAME D <br /> <br />~ H ~ c1u.a- ::to- 'f-~ <br /> <br /> <br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT <br />TImTl,..,--nTITTTmlllllll"111111 , I , llllll'll , I , I111111 , 11I111 , . 11111111 . I , . I1111 ' 1111111111'11 . . 1II111 . . 1111I1111111 . 1I11 , . 11111111 . 11111 . , 1111 <br />[21 <br /> <br />PARCEL ID#I <br /> <br />SUBDIVISION <br /> <br />11f-c!)~ -iXl- (!JOro" 081700- CKJ/O <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />D <br />D <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />ROOFING <br /> <br />I <br /> <br />I AMP SERVICE D PROGRESS ENERGY D <br /> <br /> <br />I tJOt.,/~r\-L~tA ~ <br />I L ,,,,^~. 0 ~"aJ <br />VALUATION OF MECHANICALlNST ALLA TION tZ(f\' () WA '-rho 01\ - (}..A. J"'- <br />. Jf' t)\ O' f c)N""".Ie f;>~ <br />D SPECIALTY D OTHER * S1'<6"'- t~(~~ <br />I FLOOD ZONE AREA DYES DNO Bb~ <br /> <br />W.R.E.C. <br /> <br />BUILDING <br /> <br />7 S, oClC> <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br /> .~c <br />BUILDER ?c_u_\ ~ IS <br />SIGNATURE 1(0 N I FEE CURRENT I(ON <br />Address License # <br />ELECTRICIAN <br />SIGNATURE FEE CURRENT <br />Address License # <br />PLUMBER ALL 5 'C.-R\.J\ OL PI umlo. 'l)~ <br />SIGNATURE I CD N I FEE CURRENT I ~ I <br />Address License # I <br />MECHANICAL ALPHA "" IL <br />SIGNATURE Il";A N I FEE CURRENT I {y ])N <br />Address License # <br />OTHER COMPANY <br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br /> <br /> <br /> <br /> <br /> <br />Address License # <br />111111111111111111II111111I1111111111II11111111111I1111I1111111111I111111111111I1111I1111111111111111111111111I111111111111111111I1111111111111111 <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 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 wI 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 />......11...1111.......11.......111..........11.1111.111111...1.................................................................................... <br />Directions: <br />Fill out application oompletely. <br />Owner & Eontr$cton sign back of application, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) <br /> <br />Agent (for the oontractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNT~R.~ERMITTING (Front of Application Only) <br />Reroofs . . Ss'tVers Service Upgrades AlC <br />I I <br />Driveways-No~over Counter if on public roadways"needs ROW <br /> <br />Fences (Plot/Survey/Footage) <br />