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<br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br />;~-Z2.-()y <br /> <br />Owner'!) Name <br /> <br />i3e ~ L'Y) <br /> <br />U;I\~.C- <br />/. (Xl r 2 t.~J,',tl-l,i )J <br /> <br />Owner's Address I 7 2-~3 1/191, )~ol <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />172.17 <br />\O,lK <br /> <br />JOB ADDRESS <br /> <br />11, -~J, I. MI <br />, <br />RQn <br /> <br />L..e,Iy.e.II,//) ~ n I LOT # I <br /> <br />PARCELlD# I ;')/- 1- 5- )., 1- 0 I 00 - b()()()O- 03 </0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />1$ <br />o ELECTRICAL 1$ <br />o PLUMBING 1$ <br /> <br />o MECHANICAL 1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS 1 <br /> <br />BUILDING <br /> <br />) o{:.;e- <br /> <br />I <br />~ <br />o <br />o <br /> <br />~ <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />~~::~ ~ y~ ;H~'1/~ /"d <br /> <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br /> <br />'...... <br /> <br />81,IJ,,00 <br />J <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />o <br /> <br />D <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />~ <br /> <br />11.11.111."P....,.,.,.II"'...llt"IIIII'II."'...","1.1"11...1111.1.111'..1111..'111..111"'1111111'1'1.IIff..'I.....I.'..."'r'...".II""1 <br /> <br />BUILDER COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N <br />Address License # <br />ELECTRICIAN COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N <br />Address License # <br />PLUMBER COMPANY <br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br />Address License # <br />MECHANICAL COMPANY <br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br />Address License # I <br />OTHER ~~'//o GnC/UJ!L .. <br />SIGNATURE 'ill N I FEE CURRENT I Y/N <br />Address License # <br /> <br /> <br /> <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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />.".PROPERTY SURVEY required for all NEW construction. <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111 <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 A1C Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />