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<br />B13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br /> <br /> <br />Date Received <br />1111111111 <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />l0.sJ1 <br />I <br /> <br />Fo}(V\'t,l.Ov Dr <br /> <br />I <br /> <br />D NEW CONSTR D ADD/ALT D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D ,COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I <br /> <br />DESCRIPTION OF WORK ~ VO,- -r t-.v / q J 0 ~"'Ur C /?F ??~ ~J.-,I r H <br /> <br />BUILDING SIZE I ~Q FOOTAGE I i I 5' L HEIGHT I I <br /> <br />..11....11....111..........'.,11..111...11....'111....11...,.....11...11,..........'111.............,..,.....'11.'11'......111...................'11 <br /> <br />1$ 5 t.j UJ/ lj U <br />1$ <br />1$ <br />1$ <br />DGAS ~ <br /> <br />FINISHED FLOOR ELEVATIONS r <br /> <br />SUBDIVISION <br /> <br />~ k.i Us F I 3 -5~ij:P- <br />PARCEL 10#1 05- 2-10- 2,1- 01 2..-0 -OOL; ou -O,cf() <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE D <br /> <br />LOT # <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />D <br />o <br />o <br />o <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />ROOFING <br /> <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />DYES <br /> <br />DNO <br /> <br />111""1111"'1""""111""111"'1"'111"1'1"""111111'.....11'."111.....',"""111111111...".'11'.""""'1'111111111111""""1""1' <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN I <br />SIGNATURE . <br /> <br />Address I <br /> <br />PLUMBER I <br />SIGNATURE <br /> <br />Address I <br /> <br />MECHANICAL I <br />SIGNATURE , <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED Y/N FEE CURRENT Y/N <br /> License # <br />COMPANY <br />REGISTERED I Y I N FEE CURRENT Y/N <br /> License # <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 />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />OTHER <br />SIGNATURE <br /> <br /> <br />(....ilvS~S 2- Pc)~c,K{lrS- <br /> <br /> <br />License # I <br /> <br />lJ1~m~cf~~4f<f:'~ <br /> <br />'1;C ( License # k::" L?OJ 7 7 S--7 <br /> <br />Address <br /> <br />111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 atter 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 atter 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 />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 111111 11111 <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 <br /> <br />Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />