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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 L 0 VLv\. <br /> <br />Owner's Address I S I~ 0; <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />Owner Phone Number J'lJ 77~"'" &72] <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />I ~ -+-4 <br /> <br />I <br /> <br />E3 <br />D <br />D <br />~c.~ ciA. Vj ~j <br /> <br />BUILDING SIZE I I SQ FOOTAGE I Q( 00 HEIGHT I <br />111111111111"11111111111111111111111111111'111111.1"1111.111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111 <br />~ BUILDING <br /> <br />I <br />I <br />I <br />I <br /> <br />D GAS g-- ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I11111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />I G030 9-1/-.. 81. <br /> <br />~SOk. SvJoAl. <br /> <br />D /NEW CONSTR <br />~ INSTALL <br />PROPOSED USE ~ SFR <br />TYPE OF CONSTRUCTION 0 BLOCK <br /> <br />DESCRIPTION OF WORK I i-<. <br /> <br />SUBDIVISION <br /> <br />PARCELlD#1 ()Q.- <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />~.J <br /> <br />o <br />o <br />o <br /> <br />;JG-ll- OI~O-CoIOcO- ()OS( <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />DEMOLISH <br /> <br />I <br />D <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />W.R.E.C. <br /> <br />D <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />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 subdivisionsllarge 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 />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <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 />License # <br /> <br />Y / N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # I <br /> <br />I R'. 'J...,v, ~ r60 0 .).. ,A., ::T-c. <br />'lfY/ N I FEEC~I Y/N I <br /> <br />License # I eee' s J. .r J u J- <br /> <br /> <br />Di~~~ti~~~I:' I . . I I I . . . . I . . I I . . I I I I . I I I I . ',1 I I . . . I I I . I I I I I . . I I I . I I I I I I I I I . I . 1'1'1' . I . I . . 1.1. . . '.1. . . I . I I I . . . . . . . I I I I I . I I I I I I I I I . . . . . . . . . . . . . . . . . . . I I I <br /> <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 A1C Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />