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<br />813-780-0020 <br /> <br /> <br />Date Received <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />'6 ]-)8" ~~ 0- <br />Z 4?~Y' hllk:, 'PI ,~"'tl2owner Phone Number I <br />I Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I S5,k) )0+;/:5 f <br />I <br /> <br />" JOB ADDRESS <br /> <br />B <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION !:Zl <br /> <br />" DESCRIPTION OF WORK I ad d I ~ ( \ ~" <br />I (4- ' , ~t-2 ," I ILl' 3 u <br />It; )( 27 SQ FOOTAGE ~ <br />. <br />.,1,..,11'...111,.,..,1..,1.'."....1,...".,11........."..".....".....111,..."'..........1111"...........,..,111......,11""""............ <br />~J SOO <br />G, I JJc) <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />2.CPhft' hi 'lis (- , <br />I PARCEL ID#I <br />~ <br />D <br />D <br /> <br />LOT # <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />I 2. - J-~- 2.J-OCl20~ Q)3('Y)~' O~,~h <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 <br /> <br />o <br />o <br />o <br /> <br />DEMOLISH <br /> <br />I <br />o <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />[8] <br /> <br />BUILDING <br /> <br />1$ <br />1$ <br />1$ <br />1$ <br />o <br /> <br />ROOFING <br /> <br />~ <br />~' <br />rzj <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />(" <br />G) <br /> <br />GOO <br /> <br />MECHANICAL <br /> <br />000 <br /> <br />D <br /> <br />GAS <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />HEIGHT I <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />W.RE.C. <br /> <br />AMP SERVICE <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />1111"'11""11111111111"1"1'11""""'1"11"11111111111.'...........'1111111"'..'.,1,....'111"'1".'."""1""11""1""1'1111111""'11 <br /> <br />)~~~~R~ K~ d~ <br /> <br /> <br />Address _ ' <br /> <br />ELECTRICIAN I ~ ~ IJ" n " ;./ ,. '')'" 11 J. t.-/ <br />/SIGNATURE ~ dl ~ <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I <br />I <br />I <br />I <br />I <br /> <br /> <br />License # I I <br /> <br />I tc-~ L r i "'~.rG ~C 5c~\!J{L:S O~ n 1 <br />-'if N. FEE CURRENT I Y f N I ;rtfr~ <br /> <br />License # I CAe 1.9/lf8(."g I <br /> <br />I <br />I <br /> <br />+lc,lI\-C. ClLv'(I ~.r <br />I Y / N I FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />11f) me.. () (.;/.1 e ....- <br />'I Y / N I FEE CURRENT <br /> <br />YfN <br /> <br /> <br />PLUMBER <br />/ SIGNATUR,E <br /> <br />Address <br /> <br />/ MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br />/t'JtJ"1 Jfb hlYJ 6tJW R-d' <br /> <br />OTHER <br />SIGNATURE <br /> <br />License # <br /> <br />H a,V\{. C)vl1-e /' <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Y/ N <br /> <br />Address <br /> <br />License # <br /> <br />111111111111111 11111111111111111111111111111111111111111111111111111111111 1 111111111111111 1 1111111111111111111111111111111111111111111111. J ., J II J <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 w/ 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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />11111111111I111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111"1/1111111111111111 <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. CAlC 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />