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<br />8'13-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date'Received <br />11111111111 <br /> <br />Owner's Name -r ~ 0 <br /> <br />Owner's Address I ~ ( S-I <br />Fee Simple Titleholder Namel <br /> <br /> <br />P4LM~;L <br />I b t'~ S t-- <br /> <br /> <br />I <br />I <br /> <br />I <br />2- "'-'- "I ~ (' / "33),/ L I LOT # I I <br />PARCELID#lo 2_ - LI.o- 2-.) - 0 I &-0 -00000- d/l d <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I Co l S-t (~~ 5' +- <br />I ~~'\ <br /> <br />I <br /> <br />D NEWCONSTR [=:J ADD/ALT D <br />D INSTALL CJ REPAIR <br />PROPOSED USE D SFR c==J COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I <br /> <br />DESCRIPTION OF WORK I ~ voo /' ~y St c.J( A '2 r ~~'" C/fF "Z'-h h <br />C/ <br />BUILDING SIZE I I SQ FOOTAGE I ;....Lls'( I HEIGHT I I <br /> <br />'.1111.1111....11....11..11...11..111....1111..1111...111..11...111...1111...111...1111..111......11........11,..11....1111....................... <br /> <br />D BUILDING 1$ y rOO. () (/ I VALUATION OF TOTAL CONSTRUCTION <br /> <br />D ELECTRICAL 1$ I AMP SERVICE c==J PROGRESS ENERGY <br /> <br /> <br />D PLUMBING 1$ I <br />D MECHANiCAL 1$ I <br /> <br />D GAS ~ ROOFING c==J <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />DEMOLISH <br /> <br />D <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />'.""""'1....1"1.'."111".""..""'11111...""111111'11'.........1111..........,11.1111...111..'11'.."...."11.....111'..11'11""'11"" <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />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 I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />~~H::rURE ~L I <br />Address I fD f3DX I (If" J'c,,,, A-nn / I ~3J76 I <br /> <br />111I111111111I1111111111111111I11111111111111111111111111111111111I111111I1111111111111111111111111I111I11111111111111111111111111111111I111111111 <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 />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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />1111111I111111I11111111111111I1I111II11I11111111111II1111I111111111111111111111111I1111111111111111111111111I1I111111111111111111I11I1111111111I11 <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. (A/C 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 A/C <br /> <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 /> <br />FEE CURRENT <br /> <br />License # <br /> <br />I.Ccc OJ7;fFl <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />