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<br />1::13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />1<t~1 <br /> <br />Qate Rece lved <br />1111111111 <br /> <br />Owner's Name r. <br /> <br />Owner's Address '3 r b '5 ) <br />, <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />'Tirv <br /> <br />Fee Simple Titleholder Address <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />LOT# I ~3 <br /> <br />55- 25- 2-1 ~ 00 l 0- /lScY0- 0<<X:) <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />"3 g ,,~ I 'TA r r ,TJ. <br />((?~'J 1J4f!('f{ V (1/R I <br />, <br /> <br />E3 <br />D <br />D <br />j.,/~ !h~t/ <br /> <br />SQ FOOTAGE I <br /> <br />2 -JI,Jlr' 3'?5 '//J <br />PARCEL 10#1 <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br />I )~ <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />I <br /> <br />.'....111......".....,...11........'1'..11....11..111,......111........11...111..111...111..111'.....11......'11'.."..".....11.11..'111'...11111. <br /> <br />HEIGHT I <br /> <br />BUILDING SIZE <br /> <br />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION <br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 W.R.E.C. <br />0 PLUMBING 1$ I <br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION <br />0 GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo <br /> <br />1"11'.".'......""...........,'......'.'11...".,11...,..."""'.....'.."'11""'1111'.....""1'.11.11111"""'1111111111'111""1"'111111 <br /> <br />~kk/ <br /> <br />COMPANY t//#Mr <br />REGISTERED Y I N I FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED I YI N FEE CURRENT Y/N <br /> License # <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />1111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111 <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 />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 wI 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 />11111I111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111I11I111111111111I11I1111111111111111 <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 (PloUSurvey/Footage) <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />