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<br />City of Zephyrhills Permit Application <br />Building Department 9J I ~ _ <br /> <br />BI~ <br /> <br />813-780-0020 <br /> <br />Fax-813-780-0021 <br /> <br />Date Receiv{ld <br /> <br /> <br /> <br />Owne(s Name <br /> <br />Owner's Address I to15d Do. ~r rest LJLLy <br />Fee Simple Titleholder Namel <br />Fee Simple Titleholder Address I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Luo5~ 00 hc'rel?lLL J~ \~ <br />1D:t\J\6.-Q.~t ~\ote~ ~~~ PARCELlD#1 Oa-~lo-dl-Od&)O-ODOOO-OI&SO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />D NEW CONSTR D <br />D INSTALL D <br />PROPOSED USE D SFR D <br />TYPE OF CONSTRUCTION D BLOCK D <br /> <br />DESCRIPTION OF WORK ~ ew SWI r<"\mi ()9 Pool <br /> <br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111'11111111111111111111111111111 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/All <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />0 BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I ~015. (Jb I <br />[{-SLit tJO I <br />b15.0i) I <br />I <br /> <br />ROOFING D <br /> <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W.R.E.C. <br /> <br />D <br /> <br />PROGRESS ENERGY D <br />~Oc.:---- <br /> <br />OTHER <br />[::::J YES <br /> <br /> <br />VALUATION OF MECHANICAL INSTALLATION <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 />I1111111111111111111111111111111111111111111I11111111111I1111I1111II11111111111II1111I111111I1111111I1111111111IIII111111I111111111111111111111111 <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 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 onsile, Construction Plans, Stormwater Plans w/ 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 />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />DNO <br /> <br /> <br /> <br />~fL~EN~(f)N I <br />License # I c-pe 1~l1f <br /> <br />IJ:};;./ -J-/' /1 fE:J~r:. b,. - C- <br />. I GJ NI ( FEE CURRENT r<tf:' I <br /> <br />License # IlS.C/3()oIY8'"3 <br /> <br />1'1&~" I W;~(~~R~..i' ~~,pr'1 .1nJ <br />License # I~~(' '~~lDDd. I <br />I <br />I <br />I <br />I <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 />.11.111111111111...11...11.....................11111..111.1....111111111111111111111...........11......111.1........1.1.........1.11..1..11..111.1 <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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />