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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 />Date Received /.:J /) ~ <br /> <br />Owner's Name !...O/ll 41//A/lA/4 <br />Owner's Address 173 if:) t1iPU-G~. A2 i VG <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />113 Lfs ItPPLL~ /)/L, <br />f/h-IW* I~ <br /> <br />D NEW CONSTR 0 ADD/ALT D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR 0 COMM D OTHER <br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D <br /> <br />/bw,.; f~V' /lL~ ~ ~mu- Alet-J t ' <br /> <br />I SQ FOOTAGE I I <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN D MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />AMP SERVICE <br /> <br />o <br /> <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />D <br />D <br /> <br />BUILDING <br /> <br />93Z~O <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />Al :JJ!!:-- <br /> <br />VALUATION OF MECHANICAL INSTAL <br /> <br />PLUMBING <br /> <br />D <br /> <br />MECHANICAL <br /> <br />SPECIALTY D OTHER <br /> <br />FLOOD ZONE AREA DYES <br /> <br />DNO <br /> <br />..11......11...11...11....1'.'..'".......",.'.".'1......11........'111,."'."'11..,1111"...'.....1111..11..".11111.....""".1'1....'11111. <br /> <br />I <br />13.IJrUzJWJ If, ~5S'30 I <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I ~~(Sg,1IA IIV~ <br />1>6f ; I N 1'- FE~~Ttb, I <br /> <br /> <br />License # I <br /> <br />BUILDER 1.-:....---11' J /~j <br />SIGNATURE ~ ~ <br />Address J505 I-Iw't 6 (.) PlST <br /> <br />Y/N <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />Y I N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 />11I111111111111 1111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 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 />I111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I <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 NC Fences (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadwaysooneeds ROW <br />