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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 />Dale Received <br /> <br /> <br />if 1~( <br /> <br />Owner'sName W/"". ~ /71orri <br />Owner's Add.... I ~5(;~ C:hr../k.v AY~ <br />Fee Simple TItleholder Name I A/ ~ /'(7 X <br /> <br />7ii,.,-._ I <br />~/?1 <br /> <br />Owner Phone Number <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Fee Simple TItleholder Add.... I ,;t/ /-'1 <br />&:-cP/v 6q# <br /> <br />D <br /> <br />D <br /> <br />D <br /> <br />D MECHANICAL r <br /> <br />D GAS ~ ROOFING <br />FINISHED FLOOR ElEVATIONS <br /> <br />(C? k-~ I LOa I <br /> <br />PARCEL 1011 tJ ? - 7t, -21- cJd/d- t? Z'/a;J- dtJZO <br />a (OBTAINED ~ PROPERTY TAX NOTICE) <br />E3 NEW CONSTR ADD/ALT 0 SIGN D MOVE D DEMOLISH <br />INSTALL ~ REPAIR <br />PROPOSED USE 0 SFR ~ COMM 0 OTHER I <br />TYPE OF CONSTRUCllON 0 BLOCK 0 FRAME 0 STEEL D OTHER I <br />I ~~4-/-! ~~~;rn'" ~ <br />DESCRlPTlON OF WORK ~ <br /> <br />BUILDING SIZE 1/ f / ;; /S(J l' SQ FOOTAGE I .,l' -?; ;7aJ ..51 <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />HEIGHT I <br />: <br /> <br />;zo/ <br /> <br />BUILDING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION / Cl J>: ..:/ 9t1' ' <br />I <br />AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C. <br /> <br /> <br />tJ ~~/ <br /> <br />, <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY 0 OTHER <br />FLOOD ZONE AREA DYES DNo <br />COMPANY <br />REGISTERED LYi.!!.J FEE CURRENT LYL!U <br /> License # <br />COMPANY <br />REGISTERED LYi.!!.J FEE CURRENT LYL!U <br /> License # <br />COMPANY <br />REGISTERED LYi.!!.J FEE CURRENT LYL!U <br /> License # <br /> LYi.!!.J FEE CURRENT LYL!U <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />/--4' ' <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Add.... <br /> <br />ELECTRICIAN I <br />SIGNATURE <br /> <br />Add.... I <br /> <br />PLUMBER I <br />SIGNATURE . <br /> <br />I <br /> <br />Add.... <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />Addreaa <br /> <br /> <br />COMMERCIAL <br /> <br />License # I <br />~~ I~~d~~ <br />~ /".-- IN FEECU YIN <br /> <br />Addren ~~/ N- C/W";Y J~/,;;r~~ /"'Z'" ~~7 License # I L"eC",.-G"z 63.csi <br /> <br /> <br />RESIDENTIAL Attach (2) Plot Plans: (2) se1s of Building Plans; (1) set of E~ Forms; R-O-W Permtt for new construction, <br />Minimum ten (10) woridng days alter submittal date. Required onsite, Construction Plans, Stonnwater Plans wi Si~ Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Perm~ for subdivisions/large projects <br />Attach (3) complete se1s of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permtt for new construction. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans wi Si~ Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permtt for all new projecta All commercial requirements must meet compliance <br />Attach (2) se1s of engineered Plans. <br />-PROPERTY SURVEY required for aU NEW construction. <br /> <br />OTHER <br />SIGNATURE <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out application comp-.y. <br />OWner & Contractor sign back of application, notarized <br />If over $2500. a Notice of Commencement Is required. (AIC UPllrlldee over $5000) <br />- Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OV~R COUNTER PERMITl1NG (Front of Application Only) <br />~ Sewets SeMce Upgrades NC Fences (PIotISurveylFootage) <br />_y.Nol over Counter if on public roadways..needs ROW <br />