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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 />f- ~l5~ 3 <br /> <br /> <br />Date Received 2- - ~r:ro '6 <br />Owner's Name J-f C F 1- 1/5 Lt C <br />Owner's Address 1011/ /5 . Coil? efbttcL (({( S te 13- 510 <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br />182/4 LC{(D 5-re. S-h,-e cf <br /> <br />~e.s-f(L 001:-3 I <br /> <br />B <br />D <br />D <br /> <br />DESCRIPTION OF WORK I p {u f- [VI oel e/ <:; -e-f - LiP <br />. <br /> <br />SQ FOOTAGE I <br /> <br />JOB ADDRESS <br /> <br />I LOT # /I L{ C; <br />PARCELlD#12LI- 2 &-21 ~ 06?Jj -00000- IL{GO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />BUILDING SIZE I 3G X 14 <br /> <br />Cj'" '~~I~'~;~~"""" i' ~'~~~'_' ~.~"....,..."....,., .~~~~~~;~~ ~~.~~~~~ ~~'~~~~~~~;~~.....,..,.,........".,...,...........,.. , <br /> <br />0' ELECTRICAL 1$ [;(\(). (; <.J AMP SERVICE I VJ D PROGRESS ENERGY 6 W.R.E.C, <br /> <br />cz:j PLUMBING 1$ 250. 0.) <br /> <br />czj MECHANICAL 1$ IPOb.OJ <br /> <br />o GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br />D <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />L/qg <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER I Pa/ J.. ft/10 d..f I <br />STEEL ~ OTHER I <br /> <br />HEIGHT I <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />'.'11111.....'.'11111..11...."""'111111111,..11..'.""'1111111111...'111111.......11......1111"11111111.......t""I""'IIIII.'III"'IIIIIII <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />ELECTRICIA <br />SIGNATURE <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />License # Ie ROO/2cr/O <br /> <br />~iA-t-f('tll:d d ,MIlS <br />~ / N I FEE CURRENT lOr' / N I <br /> <br />License # I rJ-/00060C{?O <br /> <br />/30.. hvs <br />I Y / N I <br /> <br />FEE CURRENT I Y / N I <br />License # ICAco 459c.f g <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />I1111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111 <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 subdivislonsllarge projects <br />COMMERCIAL 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 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 />111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111II11111111111I11111111111111 <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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />