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<br />8 '13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br /> <br />Date Received \ <br />111/1111111 <br />Owner's Name ~Y\. -l L ""- cl'\. e..l u " {. V\--> <br />Owner's Address II (p c.. i q fll V\ iZO( <br />Fee Simple Titleholder Namel <br /> <br />(3vurr: <- I V / <br />, <br /> <br />o J (., V II <br />I <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br />-~'iL <br /> <br />'~ \ -h ''- """ <br /> <br />[)" 2 h.115 '~~S;~L <br /> <br />PARCELlD#1 /'"L - 2-/.; -LI-_bo3u - DoL(O 0 -00 $0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDR.ESS <br /> <br />I) <br />I <br /> <br />I <br />E1 <br />o <br />o <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />E3 <br />D <br />D <br />R-e:.- Yt.rb-r <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />I I <br /> <br />,"....'11...11...11...11.11,..."..111....,....111...1111111.'.11....11...'.11..111....'...'11'...111.11.....1111111....,11.'....,....,........11111 <br /> <br />BUILDING SIZE <br /> <br />0 BUILDING 1$ !:70U~OO I <br />0 ELECTRICAL 1$ I <br />D PLUMBING 1$ I <br />D MECHANICAL 1$ I <br />o GAS . ~ ROOFING D <br /> I <br />FINISHED FLOOR ELEVATIONS <br /> <br />LOT # <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />C:;/I-,c <br /> <br />yo <br /> <br />OTHER I <br />71M~~I'h-( <br /> <br /> <br />HEIGHT I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />111111.,1."'."'1"'111111"'1'11""...'111,1""",11111111111"'1,.....'11.11111"11111111111"1111,......1111111.."""111111,......,1111111 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br /> <br />po <br /> <br /> <br />yt S'L <br /> <br />Address <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />License # I <br /> <br />ISLD tK3 ~vt~~ tcL>i,.~ <br />I Y / N I FEE CURRENT Y / N I <br />License # Ice LOj-j C}Jt <br /> <br />11I111111 1111 11111 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />1111111I11111111111111111I11111111I111111111111II1111111111I11111111111I1111111111I11111II111111111111111111I11111I1I111111111I11I1111111111111111 <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. (A1C 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 />Driveways-Not over Counter if on public roadways..needs ROW <br />