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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 />Owner's Name <br /> <br /> <br />'''2..e.W <br /><I\VGV <br /> <br />ski" <br />OC,," k...s <br /> <br /> <br />Ov <br /> <br />Date Received <br /> <br />\~ <br />Owner's Address (0 2. ~ S- <br />Fee Simple Titleholder Namel <br /> <br />d ~ /LJ' jJ V <br /> <br />PARCEL 10#1 0 3 - L {q - L1 :- (:) I LA - f0acbO-/ J <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />I <br />I <br />I <br />I <br />cfol <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br />I C:, L{-L~ 5," (1./( v <br /> <br />I S i " v~ v 0 Or. // J <br /> <br />LOT # <br /> <br />I <br /> <br />D NEW CONSTR D ADD/ALT D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I I <br /> <br />DESCRIPTION OF WORK Q...e...~ t-o 0 f Wi CA...- 30 ~I'""' CJ ~ ~ ~ It{ t:.r#t"tJ <br /> <br />BUILDING SIZE I I SQ FOOTAGE I 3 ~ 0 I HEIGHT I . I /' <br /> <br />I'r . I I I . . I . I I . . . , r . 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 . . r I . <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />D BUILDING 1$ <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />fr'J- { ~ (:)J <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />'1..JII"'.ft"..,...'...'IIII'."II"'....t,.."..'II.1"1""111""111""1'1111"'11"'111111'1'11111'111..,....,.....,111,......"11."..."11 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE , <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />~'~~~URE ~ <br /> <br />Address I "3 1 v I 0 S tz-- s;- L <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTEREO <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />11I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 subdivisions/large projects <br />COMMERCIAL 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 Sill 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 />11I111111I1111I11I1I11111I1111II111I11III11111I111111111111I111111111I1111111I111111111111111I111111II1II111111111111111111111111'1111111111111111 <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 AlC Fences (Plot/Survey/Footage) <br /> <br />(7c -0 ~><..l \ W <br /> <br />License # I ('C{' 0 5-7/;-7 <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />