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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application ,~-11<(7 Fax-813-780-0021 <br />Building Department ~ <br /> <br />Date Received <br /> <br /> <br /> <br /> <br />(.'V\r\e,tk <br />Owner's Address I Co '2- 0 ~ {--t---4 V\ il'V\) h Y\ <br />Fee Simple Titleholder Namel <br /> <br />Pr <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />1l,2D~ <br />I <br /> <br />LCf~Y ~ ,'/I, ~( :5 -3s-i L I <br /> <br />PARCELID#I 0 ~ - Zlo - 2. {- ar2..-0 -cOCOO-1170 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />~V\ j\'~ tn Y\ .tJk <br /> <br />I <br /> <br />D NEW CONSTR r=J ADD/AL T D <br />D INSTALL D REPAIR <br />PROPOSED USE D SFR D COMM D OTHER I <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I <br /> <br />DESCRIPTION OF WORK I P---e.-'fD':::; -{ W I ~ --:1 0 "f'C4.v 0 ~ F It'~ bey It'''\.(,, <br /> <br />~~~~~,I~~.~~~~....I....,.................. .1.... .~~.~~~~~~~ !.??::.. .~1... .1.,1.... ,~~1~~.~.1....... ...............1....................... <br /> <br />o BUILDING 1$ 5 ~ yo. (> U I VALUATION OF TOTAL CONSTRUCTION <br /> <br />o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY <br /> <br /> <br />o PLUMBING 1$ I <br />o MECHANICAL 1$ I <br /> <br />o GAS ~ ROOFING D <br />FINISHED FLOOR ELEVATIONS I I <br /> <br />LOT # <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 />1'1111"""'1111111111""'1'1""'1""1'11111111111....1111111"'1""'1111"'.'...1111111111"""11'...111"""11"""1111'1'1111111111"'1 <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/ N FEE CURRENT <br /> <br />Y/N <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 />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />I S L.ot7l?,(c~;,. ~() -Hy T J1 <br />I Y I N I FEE CURRENT I Y I N I <br />License # Ice c 0;) 7157 <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11II11111111111111111111111111111111 <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 onsile, Construction Plans, Stormwater Plans wi Silt Fence installed. <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects <br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safely 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 Pennit 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111 <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 />