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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 />Date Received <br /> <br /> <br />Ib.2-0 <br /> <br />Owner's Name <br /> <br />(9 ~"'u) V e; 'S <br /> <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />...;:- 't 0 'L <br /> <br />CD A LL <br /> <br />~L\.?~, <br /> <br />LOT # <br /> <br />I <br />I <br />I <br />I <br />-60,d <br /> <br />Owner's Address s.- Lj- c) q . <br />Fee Simple Titleholder Namel <br /> <br />G~LL <br /> <br />~L.LJ ;":'l <br /> <br />Fee Simple Titleholder Address <br /> <br />I <br /> <br />E3 NEW CONSTR D <br />INSTALL D <br />D SFR D <br />D BLOCK 0 <br /> <br />I (i::.. ~b>..~",. \...-\. C:.> l'\ '\ '"\- <br /> <br />SQ FOOTAGE I <br /> <br />PARCEL 10#/ \ \ - '2 (p .' 2..1 - DC) \ b - i 7 2.00 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />~c...t;.i'- \-\;0(-:::-- \.\ t. <br /> <br />BUILDING SIZE <br /> <br />111"lflllllllflllllrr,I'I,I'IIIIIIIIII"I"I'II'I,I'1111111'111'11""1'11""'11111111'11"1111111'111111'111'lllrllll'IIII,'IIIIII"'IIIIIII'111 <br /> <br />HEIGHT <br /> <br />D BUILDING 1$ I <br /> <br />D ELECTRICAL 1$ ~ \. t...:J 00 I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS D ROOFING 0 SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII1I111111I111111111111111II111I1II111111111111111111I111111111111I111111111II1II11I11II111II1 <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C, <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER I <br />SIGNATURE <br /> <br />Address I <br /> <br />ELECTRICIAN I~ ,r-7i>'D ~ <br />SIGNATURE . ~~ <br /> <br />Address I '3, "l D L \ \5:::\,;\ ~ uJ oJ C::t-, - -z.., \\ l L.L.> <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMMERCIAL <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I COMPANY <br />SIGNATURE : REG""'><ED Y I N I '" CURRENT Y I N <br /> <br />Address I I License # I I <br />1I111111I111111111111111111111111I11111111I1111111111I111111111I1111III1111I11111111111I1111II111111II111111111111;,1111111111,1111111111111111111 <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 wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />Attach (3) 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 wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />'I Y/N <br /> <br />License # <br /> <br />SIGN PERMIT <br /> <br />DI~~~t;~~~': . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> <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 NC Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />