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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 />Dat~ Received <br /> <br /> <br />PI()..G(. <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />url1 ~ ~ <br />~f1. -'nn CxS!/' <br />I <br />I <br />I <br />I LOU I ~ I <br />JOSOl> CIJ 00 I <br /> <br />Owner's Name <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />I t-050 Ct4A I eo,-\If"Vo...( 0.. <br />I ~~~(~jlls CDlolta~ PARCEL 10#1 :ss 25 ~, 0010 <br /> <br />(OBTA'NEO FROryROPERTY TAX NOTICE) <br /> <br />D NEWCONSTR D ADDIALT D SIGN [Z] MOVE D DEMOLISH <br />D INSTALL D REPAIR <br /> <br />PROPOSED USE D SFR 0 COMM [5' OTHER ~.$O"tQ., <br /> <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL M OTHER I 'F.-t'< o(l""4\l(\"{ <br /> <br /> <br />:::,::~:::o,wo.. I AM( :-,~~E4 ~~(, ~~"tr""IL~ 1~ 0 <br /> <br />- - ~.,h_ a" -"'"" - <br />U\)~~c:..~ <br />C~ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />BUILDING <br /> <br />D <br /> <br />D <br />D <br />D <br /> <br />D <br /> <br />1$ 'if, olk.~ <br />1$ <br />1$ <br />1$ <br />D <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />GAS <br /> <br />ROOFING <br /> <br />I <br />1 <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS Et~ERGY <br /> <br />D <br /> <br />WREC <br /> <br />ELECTRICAL <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY ~ OTHER <br />FLOOD ZONE AREA DYES <br /> <br />~OL ~~l~~ <br />~f'n - 2((2,.. <br /> <br />PLUMBING <br /> <br />DNO <br /> <br />mr <br /> <br />r <br /> <br />- <br /> <br />v <br /> <br />, <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED YI N FEE CURRENT L..Yi!:U <br /> License # <br />COMPANY <br />REGISTERED YI N FEE CURRENT L..Yi!:U <br /> License # <br />COMPANY <br />REGISTERED YI N FEE CURRENT L..Yi!:U <br /> License # <br />COMPANY <br />REGISTERED Y/N FEE CURRENT L..Yi!:U <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Address <br /> <br /> <br />License # I <br /> <br />(,01. ~ if(. f> <O~ e c: <br /> <br />Y I N FEE CURRENT <br /> <br />OTHER <br />SIGNATURE <br /> <br />,'on <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />I OI''lI'l.elOD 11495 <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Perm,t for new construction, <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence ,nstalled, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />Attach (3) complete sets of Building Plans plus a L~e 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 elt new projects. All commerc,al requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />--PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2600, a Notice of Commencement Is required. (A/C upgrades over $6000) <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 (PloUSurvey/Footage) <br />Driveways-Not over Counter ~ on public roadways. needs ROW <br />