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<br />Ei 13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br />1111111111 <br /> <br /> <br />c. bC{ v,'S <br />Dr. <br /> <br /> <br />~ <br /> <br />Owner Phone Number <br /> <br />P /ant Ci'fy 3'r OW.., Pho.. Numho, I <br /> <br /> <br />Owner Phone Number I <br /> <br />- Owner's Name <br /> <br />- OWn.(. Add,... I 2hO~ ~bi n <br /> <br />Fee Simple Titleholder Namel . am <br /> <br />- WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />I <br />B <br />D <br />D <br />-h kr(J'a.~s <br /> <br />Xcph. .33.5'-12 <br /> <br />PARCELlD#1 J 1- 2~-;LJ -oo/O~oq()OO -nIXO <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />I <br />I <br />I <br />I ~~~}ti~4 <br />I <br /> <br />Fee Simple Titleholder Address I <br /> <br />-JOB ADDRESS <br /> <br />SO()O <br /> <br />6ame <br />V; +h ~)t. <br /> <br />SUBDIVISION <br /> <br />--'0 <br />o <br />o <br />o <br />o <br /> <br />B <br /> <br />-- PROPOSED USE : vf <br />TYPE OF CONSTRUCTION <br /> <br />- DESCRIPTION OF WORK I H:rt- mop <br /> <br />I <br />1$ 4,000. bO I <br />1$ I <br />1$ I <br />~ I <br /> <br />ROOFING D SPECIALTY D <br /> <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA <br />~ <br /> <br />""111.111'....."11..'.1'1."'......."'111"'1111.''IIIII.I.IIG~I.-..III...IIIIIIIJII.......I"'IIII..."IIII,.......",..i,.......,""'.III.' <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />rooF &meJ artAO <br /> <br />I <br />D <br /> <br />ani. -Ha::.tl coaT rOo f <br />Isf1>rI <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />SQ FOOTAGE <br /> <br /> <br />HEIGHT <br /> <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE D PROGRESS ENERG: ID~ ~E.C <br /> <br /> <br /> <br />VALUATION OF MECHANICAL INSTALLATION IV <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />GAS <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />Address <br /> <br /> <br />I ~ ~P~qJ <br /> <br />RoaR ~n I r)C <br />FEE CURRENf} I Y / N I <br /> <br />License # Ieee 132(0874 <br /> <br />~BUILDER <br />SIGNATURE <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />I Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />Address <br /> <br />111111I11111111 111I1111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />111111111111111111111111111111111111111111111111111111111111111II11111111111111111111111111111111111111111111111I11111111I1111111I1111111111111111 <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 AlC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />