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<br />B13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br />(J1(),oL.-iY <br /> <br />1- '1- 0 g <br /> <br /> <br />/J1c/ .. .' ; <br /> <br />;;2c)<<>5-f <br /> <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />r:;- 5- ? G <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />16S3<.P <br />I <br /> <br />~9- LOT # <br /> I PARCELlD#1 \ '2- Zl..,. 2..\ ~ 0020. 00300. 6b~O I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br />NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH <br />INSTALL REPAIR <br />SFR D COMM D OTHER I <br />BLOCK D FRAME D STEEL D OTHER I <br />70]", /1.rAa~ c,L C hc-..crX 6) t'/- <br /> SQ FOOTAGE I I HEIGHT I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I :2 <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />1...,1,.....1....,111...1,..1,...111..11.111,...111..,11,.......111.....1111,.1111,..111,...111....."....,.......,11.11,......................... <br /> <br />D BUILDING 1$ <br /> <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ 1/3 <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <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 />()O. (70 <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />11"""11"""'11111111"'1"1111""""""'11"11.11.11,....."".'.111"..111...,1".."11....1""'..,...."'1"1'.......""....."'1'..,11 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED YI N FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED I Y I N FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED Y I N FEE CURRENT Y/N <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br /> <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />License # I <br /> <br />IP((~ St;t- LQ,v i-~ ;loc~~v/r-c <br />I Y L I FEE CURRENT I Y I N _ <br />I I~~ <br /> <br />Address License # <br /> <br /> <br />~I~HN~~URE f ~~:~~~~ Y I N FEE CURRENT <br /> <br />Address I License # <br />1I1111111111111111111I1111I1111I1111II111111111111111111III111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 onsite, Construction Plans, Stormwater Plans wI Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for sUbdivisionsllarge projects <br />Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 />11111111I111111I1111111111111111111111II1111111I11111I1111111111111I11111111I1111111111111111111II1111111111111111I1111111111111I11I1I111111111111 <br />Directions: <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 <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />