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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />OWner's Name <br /> <br />(J /7 /(. /e.s J 'J74 fY1t;' S' lfo A Ai N E <br />l3i-ucJj4Y 4t/~. I <br />I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <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 /> <br />13'700& BLLAeY19Y <br /> <br />\EI9SY ;:tCtZes <br /> <br />/lVE"'. <br /> <br />LOT # <br /> <br />I <br /> <br />;( 0" if 16=-;l.13/ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />PARCELlD#\ P6 10 PG./() () Lal :( 7 a~ <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />I <br />B <br />o <br />o <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />WORK PROPOSED <br /> <br />B <br />o <br />o <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />I <br />D <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />/1,401: <br /> <br />r:L-cc-r /l ,C,,/} L 5e/2 u (Cc To <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I <br />1111111'1111'111'11'11'1111'11111111111'11111111111111111111'1111'11111'11'11'11111111;'1111'11111111'111111'1'11'111111111'111111111111111'111111 <br /> <br />1$ <br /> <br />1$ / If 0 0 ~ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />111111111111111111111111111111111111111111111I11I11I11111111111;1111111111111111111111111111111111111111111111111I111111111111I1111111111111111111 <br /> <br />;ZOD //. <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE ~ PROGRESS ENERGY <br /> <br />W.R.E.C. <br /> <br />D <br />M <br /> <br />ELECTRICAL <br /> <br />o <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 />1111111111I1I111111111111I11111111111111111I1II11111111111111111111111II1111I1111111111111111II1111111I11111111111111111I1I1I111I11111111111111111 <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 />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 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 />~ <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICi~N ! <br />SIGNATURE . <br /> <br />Address <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />~ <br /> <br />J2~. <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />I ~+\r\ <2~{lR-lC <br />Y I N I FEE CURRENT I <br />License # I <br /> <br />Y/N <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />YI N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />.......111...........111..111..111.....1111..11........11...1111......11111..................111......11..11111.111...111...11..........11....1111 <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. (A1C 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 Applipation Only) <br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />