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<br />B 13-780-0020 <br /> <br />City of Zephyrhills Permit AppliCatiOn <br />Building Department <br /> <br />( Q^-U I v- ~ ........ ""..._ o. <br /> <br /> <br />Date'Received -d-5.- 01 <br />1111111111 <br /> <br />Owner's Name Ii b <br /> <br />Owner'sAddress I ~11 05 /'IMport ])nv~ ?,t1Jl:Nlflfs I <br /> <br /> <br />Fee Simple Titleholder Namel I <br /> <br /> <br />Owner Phone Number g; -1 g;;...- ~ K' 5 <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />3 05 IVw ort Drive" i/:s L- 83'S< J- <br /> <br />I Zt'AJ),vr f(/dae.. I PARCELID# f}6-;)j; -;J,,/ -0/30- <br />-r' I J (OBTAINED FROM PROPERTY TAX NOTICE) <br />o NEW CONSTR c=l ADD/ALT 0 SIGN D MOVE D <br />D INSTALL D REPAIR <br />PROPOSE:D USE 0 SFR D COMM 0 <br />TYPE OF C::ONSTRUCTION 0 BLOCK D FRAME 0 <br /> <br />DESCRIPTION OF WORK Is cre.et'L- t(o Om +- 0Jn c~f-e.. <br /> <br />BUILDING SIZE I /11)< I 0/ I SQ FOOTAGE I I (J 0 f/1 <br /> <br />"""'1"11"1111'1'111111111""1""111"'1"'11111..."...".......11.....11..".....11............11.",.....'..11.........111.111.111..11111 <br /> <br />1$ dq 1~. 00 <br />1$ <br />1$ <br />1$ <br />o <br /> <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />I:LECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />D <br />I <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />GAS <br /> <br />ROOFING <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />DNO <br /> <br />~ <br /> <br /> <br />Address <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> Li~nse # <br />Y/N FEE CURRENT <br /> License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATUR.E <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Addreiss <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />YIN <br /> <br />Y/N <br /> <br />Y/N <br /> <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 onslte, Construction Plans, Stormwater Plans w/ Sill Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />COMMERC11AL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new constructlon. <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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 i 1111111111111111111111 <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of appllcatlon, notarized <br />If over $2500, a Notice of Commencement is required. (AfC 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 />