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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />#- 1f!O~ <br /> <br />Owner's Name <br /> <br />f. $1 LG'. <br /> <br />Owner's Address I 4330 <br />Fee Simple Titleholder Namel <br /> <br /> <br />I ~ '6-0 B <br />'^-.b.... -t e.r ...5. <br />'20 (...... s-( - <br /> <br /> <br />Date Received <br /> <br />Fee Simple Titleholder Address I <br /> <br />I 43'"30 <br />I <br /> <br />'Zo-t'h Sl-r'C"-ei- <br />I <br />B <br /> <br />2- H; Us. <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />PARCEL 10#1 <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN 0 MOVE 0 DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />~ <br />o <br />o <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br /> <br />OTHER <br />STEEL <br /> <br />I <br />o <br /> <br />OTHER I <br /> <br />WORK PROPOSED <br /> <br />DESCRIPTION OF WORK <br /> <br />//}57 -4 L. c.... <br /> <br />I I TAGEI <br /> <br />"'...11..11...111..111......11...11....11....111........11..11...111.......'..111...11...11....111......111........,........11..."...,............. <br /> <br />D BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION -111-<.. s'SO ap <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS c=J <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDING SIZE <br /> <br />AMP SERVICE <br /> <br />o <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />I <br />/' <br /> <br />DYES <br /> <br />, <br /> <br />;JOeJ' ./ <br />L:;~ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />c==J <br />I <br /> <br />SPECIALTY c=J <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DNO <br /> <br />111"PI..",'I'I""""'II,,I'lll'I"I'IIIII'I'I"'"1'1""11111,"111"111,...,...,,,...,"'1"""11""""1"111'111"1111'111"11111""'" <br /> <br />COMPANY <br />REGISTERED <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> <br />Y/N <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 />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />, ~/// <br />f,p C/o <br /> <br /> <br />Address <br /> <br /> <br /> <br />License # <br /> <br />~/e.E f?-c; "7c C' r;()'- <br />FEE CURRENT Y / N <br /> <br />License # I 900 & /j,f (JOG I~ ibu I <br /> <br />OTHER <br />SIGNATURE <br /> <br /> <br />Address <br /> <br />111111111III11I11111111111111I111111111111111111I11111I111111111111111111111I11111111111111111111111111111I111111111111111111111I11I1111I111111111 <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 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 />11111111111111111 I 11111111111111111111111111111111111111111 I 111111111111111111 I 111111111111 I 1111111111111111111111111111 I 1111111111111111111111111 <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. (A1C 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />