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<br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />Owner's Address <br /> <br />f1 53,) LjJ- <br /> <br />Owner Phone Number 31 J -II S - 00 LJ;2 <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />---. <br /> <br />Fee Simple Titleholder Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I ~ <br /> <br />13"J.'tl <1.T~ Av <br />I ~~~ ~,... E.~"""t- I.A ~ I <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />E3 <br />[lS] <br />o <br /> <br />zl+l,ll~, ~ ~ 15 42 LOT # <br /> <br />I PARCELlD#1 \J- ~a.6 -J...l .... 0 '100 - 000 eft) - GO ~ U <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />NEWCONSTR [K] ADD/ALT ~ SIGN D MOVE 0 <br />INSTALL D REPAIR <br />SFR D COMM 0 OTHER <br />BLOCK D FRAME 0 STEEL D OTHER I <br /> <br />('~~Zztl~~ Lo""crd:L.$l4b W ~tA.\lJ. 1<t~;J.S- Sc..r~ ~fY\ <br /> <br />I I I '(:) i I vJ t ~ov\. <br />SQ FOOTAGE ssU HEIGHT l> <br /> <br />d- <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />BUILDING SIZE I' Y.x ~ I <br /> <br />I r . . I I I . . . . I I . . . I I . . . I I , , , I . , I I I , , r , I . . . . I I . I . . I I I . . . , I I , I I I I . . I I , . . . I I I . ,., I I I . . I . . . . . . I I I . I I I I . . . I ... I I . . . . . . . I I I I I I . I . . I I I . . . . . . . . . . . . . . r . . . . . . . . <br /> <br />IYJ BUILDING 1$ bl4<J. - I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C. <br />D PLUMBING 1$ I <br /> 1JOV <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />D GAS 0 ROOFING D SPECIALTY 0 OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />BUILDER <br />SIGNATURE <br /> <br /> <br />bOn I Q olTe<L , <br />~4-us ~ (lJ -cw~ <br /> <br /> <br />I toc\ - L A t ~n:. ~"'- y....... <br />I Y / N I FEE CURRENT I Y / N I <br /> <br />License # IltA 00 SFl'~ <br /> <br />"vIA- <br /> <br />COMPANY <br />REGISTERED <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 /> License # <br /> <br />Y/N <br /> <br />..#"'11- <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />MECHANICAL <br />SIGNATURE .Nt i4- <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />.AJ{,.q.. <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111111111111111 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111 <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 wi 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 />1I111II1111I111111111111111I111111111111111111111111I11111111I1111111111111111111111111I11111I1111111I111111I1I11111111111111111111111111111I11111 <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 />Driveways-Not over Counter if on public roadways..needs ROW <br />