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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 />i <br />ner Phone Number <br /> <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number~..J3 - '7 'ft..{ - Y DID <br /> <br /> <br />Owner1sName 'L<:3Ph V ~--n~. C- WI[ j-ei <br />Owner's Address I'? J 6' (' O~ f'\ 'S \" CO c.. ke.1i\.. sr Rc( <br />Fee Simple Titleholder Namerz;:le-<"') WOO c( <br /> <br />FH Slmpl. r.,.hDld., Add~~?/ff5 <br />JOB ADDRESS ~G-H-\l b \ vd <br />lD:t1 0-\- ~yH\',lbJ <br /> <br />D NEW CONSTR r::><l ADD/ALT ~ <br />D INSTALL D REPAIR <br />PROPOSED USE 0 SFR gj COMM 0 OTHER <br />TYPE OF CONSTRUCTION ~ BLOCK D FRAME 0 STEEL D <br /> <br />DESCRIPTION OF WORK I ~eeJ f.1 ci d \t? ~ e.JL ~ e:::t u<.. <br />- <br /> <br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I <br />11111111111111111111111111111111111111111111'11'111'111111'-'1"1'1'1111'1'1111'1111111111111111111111111111111111111111111"'1'1'1111111111111111 <br /> <br />SUBDIVISION <br /> <br />I LOT# I <br /> <br />PARCELID#13 i)-{l 'S --:tl-{l)/ O-O~CV-OoW <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE 0 <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />D BUILDING 1$ I <br />D ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />D GAS 0 ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />~ " f)uY <br />~ 6'~f ,au <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 OTHER <br />FLOOD ZONE AREA DYES <br /> <br />~NO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />I l-C- <br />I Y /N I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I ~~ ~ \J~~" <br />I ~T N r \ FEE CURRENT <br /> <br />License # I~ f)' 13/3 7 <br /> <br /> <br />C-to~ <br />I <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y / N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />License # <br /> <br />1111111111111I111111111I111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111 <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 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 />Di~~~ti~~~':"" -."'..".."."".,. -..,.."'..,.,...,...""."'..."'..."".."'.."'.. -"...."".... -"""......"",..,.., ~./. ';; ~b"1'.~' <br /> <br />Fill out application completely. ~ t 3'" ., t1 . <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 AlC <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />