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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 />Phone Contact for <br /> <br /> <br />C'a.5 <br />./ / , <br /> <br />Owner's Name <br /> <br /> <br />'c$. -Ie -0 <br />~ I MOI~L- <br />S15i \~-rhC;r. U~R~ILL~ <br /> <br /> <br />'6 3> 0,9 <br />Owner Phone N.u~ber ol~.-1IS'- 012.2- <br />Owner Phone Number I <br />Owner Phone Number I <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />1S'7~1 <br />I <br /> <br />LOT# I <br /> <br />SUBDIVISION <br /> <br />I ?th sr. Z {,PH- Y g I.flu. ~ <br /> <br />I PARCELlD#III~ ,-~-2J-(()()lb-tJf'OO- 0010 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />E3 NEWCONSTR c=J ADD/ALT D SIGN D MOVE D <br />INSTALL D REPAIR <br />o SFR 0 COMM D <br />D BLOCK 0 FRAME D <br /> <br />1K.-tolltf/IV9 /0 l^llndnuJ~ - ~12e COe- SI"Z-f; <br /> <br />I SQ FOOTAGE I~. d 100 <br /> <br />DEMOLISH <br /> <br />JOB ADDRESS <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br />Fl-!\: Sqly.l <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />IStoQ: <br /> <br />ROOFING <br /> <br />~D <br />I <br />I <br />I <br />o <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br /> <br />1$ ~Lt"2:5.- <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />o JREC <br />NoU <br /> <br />BUILDING <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES DNO <br /> <br />License # I Q~c.. 17 &S::S 4C1 b <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address 1"1103 <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br /> <br />, J ' J.{flOtU/LJ . <br />~V\~~t>Y"\. ~ ~~""?A r=,. 31(P~t <br />I <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />1111111I1I1111 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br /> <br />Address <br /> <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 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 />1111111111I11111I1111111111I1111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111 <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 A1C Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />