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<br />e Received <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />'7#55 <br /> <br />vner's Name <br /> <br />wner's Address I 5 q "3 if <br />:ee Simple Titleholder Namel <br /> <br />(,5:, Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />8') 3 - 8<1Cj- 0 0b j <br />g-, "3 - wd~---30~-9 <br /> <br />- JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />I S~ 34 <br />I <br /> <br />5 -If, 'Sf; <br /> <br />'ZejJ h'j y hi i /s <br />I PARCELlD#1 <br />E3 <br />D <br />Q- <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />53-- <br /> <br />PROPOSED USE m-- <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK I <br /> <br />BUILDING SIZE I 10 'XII,. I SQ FOOTAGE I J b 0 HEIGHT I <6' <br />111111111111111111111111111'111111"1111111'1111111111111'111111111111111111"11111'111111111111111'11111'1'11111111111111"11111"1111111111111" <br /> <br />I' I <br />1$ I <br />I' I Si~~S <br /> <br />I' I VALUATION OF MECHANICALlNSTAUATlON f.i1"~ J .)11" / <br /> <br />GAS D ROOFING D SPECIALTY D OTHER '. ~ . .w-~~ <br />('- - ,"\~>~r1 <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO \)-"'\' I,rt <br /> <br /> <br />~~~~~~ "I'~ '~ 1I1I1I~~1 f' ~;~ 111111111 :'*~~;;; '; I ~ ~'~""""""""I <br /> <br /> <br />Address I License # I I <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />o <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />WORK PROPOSED <br /> <br />OTHER I <br /> <br />D <br />D <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 />D <br /> <br />PLUMBING <br /> <br />D <br /> <br />MECHANICAL <br /> <br />D <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/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />Y / N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />v~0~ <br /> <br />COMPANY <br />REGISTERED I Y / N I <br /> <br />.5" If 3 L/ 6~ Sf Z ~~ d~ :3 sS-tf.;L License # I I <br /> <br />11111111111111111111111111111111111111 I111 111111111111111111111111111111111111111111111 111111111111111111 <br />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 />Attach (3) 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 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 /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br />111111111111111 <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />...11111111..1111....1111111..........111...111.111111.111.11..........111......................................................1................. <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 />