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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 />1111...11..11 <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />3'5" B - S {p 5 - (; vfpO) <br />'r~ 19-~ C//7'S <br /> <br />10 I zt, <br /> <br />Owner's Name :r Q.~o<\ \" <br />Owner's Address I 559-& q ~ ~-'t <br />Fee Simple Titleholder Namel :IC4S0"," \ <br /> <br />Date Received <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />"Z~Vvt~~\\~ <br /> <br />A:k Q(\ <br /> <br />'!{ok ~t- "2-~~r~~\\~ I ~( '5~S"(.ra <br /> <br />-zoQ.~~~:\\ s <br /> <br />I PARCELlD#1 \\- 6lU -c91 ...OOlo-loQC:O -0150 <br />(08T AINED FROM PROPERTY TAX NOTICE) <br />D ADD/ALT D SIGN D MOVE D <br />D REPAIR <br />o COMM D <br />o FRAME D <br /> <br />~ "'~ M:~.h...\ "-'/ \pC!lCl'cl <br /> <br />Fee Simple Titleholder Address I <br /> <br />5S&~ <br />5 S" 9-<9. 9""^-"S \- <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />BUILDING SIZE I l~ v. 6\4 I sa FOOTAGE I I HEIGHT I I <br />III 111111111 , 11I11 . II11I111 , . III ; . II I111 . II1111 . 111I , . . III . I II . 11111 , . 11111 .. III . 1111 . 11111111111111111111 I 1I111I11 , 1111111 " 11111111111111 . 1111 . <br /> <br />~ <br />D <br />D <br />I -:1:", ~,"o.. \ \ <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />OTHER I <br />STEEL D <br /> <br />~WS <br /> <br />OTHER I <br /> <br />1>"1 BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D <br /> <br />t..( 33~, 5"0 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br />11I1111111111I111111111111111111111I1111111II111111111I1111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111 <br /> <br />Addres <br /> <br />ELECTR~N I <br />SIGNATURE: <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE: <br /> <br />I <br /> <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />~c)~GtA~~ <br />Y I N I FEE CURRENT <br /> <br />License # I <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE: <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE: <br /> <br />Addresis I License # <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Pial 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 onsite, Construction Plans, Stormwater Plans wI 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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Di~~~ij~~~': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <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 Se"Vers Service Upgrades NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on publiC roadways..needs ROW <br />