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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 .~ _I _ <br /> <br />Owner's Name t.MO-r~ E. -t An ~<LM f'f"O~ <br />Owner's Address I 55 ~ 0} ~ St" ~phL.\fl:\~\\e; k ~~<;l{ l-I <br />Fee Simple Titleholder Namel I <br /> <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />155~9 <br />I <br /> <br />~ S+r~ T Zphy/hll~ ~ ?:>?:>9..D- <br /> <br />I PARCELID#lll -ale. ~l- aOlo. aogCjoo. ai oa <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />E3 NEW CONSTR CJ ADD/AL T 12(] SIGN D MOVE D <br />INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br /> <br />DESCRIPTION OF WORK I UP~ f4.d~ SU\J\ll 1-0 cloo ~ <br /> <br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I <br />11/"1111111111111111111111111111'1111111111111111111111111111111,1111111111',,1111,1.',1,11111,1111,",11,''11111111111111""11'11'1111111111111 <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL 0 <br /> <br />D\~heQd <br /> <br />OTHER I <br /> <br />Address <br /> <br />ELECTRICIAJ.-. {\ -;~ 1\. <br />SIGNATURE ~ ~V\ ~ <br />. <br /> <br />Address 11' 0 B~ <9Jo~ "Z2.p n~t h,l6 <br />PLUMBER I <br />SIGNATURE <br />I <br /> <br />1$ I <br />1$ qOQ.uO I <br />1$ I <br />1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />1111111111I111111111111111111111111111111111111111111111I111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111 <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />D BUILDING <br />OCJ ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br />~\Qa <br /> <br />~ <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />w.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />I <br /> <br />Fl.. ~S'31 ~ O'l-lc;J <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />TR<2-e ~ 8 €-c-t/-)'cu.l. ~ <- . <br />(y; N I FEE CURRENT Y ~ N I <br /> <br />License # I EC.~ () COl ~~ <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111I1111 <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 onsile, 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 />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />SIGN PERMIT <br /> <br />DI~~~t;~~~': I I . . I I . . I . I . . . . I I . . . . I . . I . I . . . I I I I I . I . I . . . I . I . . I . I . I I . . . I . I . I I . I I I . I . . . I . . I . I . I I . I I I I I . I . . . I I I . . I . . . I I . . I . . . . 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 NC Fences (PloVSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />