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<br />Date Received <br /> <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />813-780-0020 <br /> <br />Owner's Address C 5 31 <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Owner's Name <br /> <br />WORK PROPOSED <br /> <br />Fee Simple Titleholder Address I <br /> <br />1G,~37 FoXVVtoO( Ov <br /> <br />l2J ve.x-. OolLs I <br /> <br />D NEW CONSTR D ADD/ALT D <br />D INSTALL ~ REPAIR <br />PROPOSED USE ~ SFR D COMM D OTHER <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D <br /> <br />DESCRIPTION OF WORK I UX(~ ot '3 L.. 5 L ~/ '1 .2 ) ,~ '1 r (; 4.~ 3 -/4. b <br /> <br />BUILDING SIZE I SQ FOOTAGE L ~ 2. S (' I HEIGHT I I <br /> <br />.,.".........,................,.............................1'.....,...........................................................,.....,.........,' <br /> <br />JOB ADDRESS <br /> <br />2/"(-'(\5 (-f 3351'- <br /> <br />PARCELlD#1 03- 2-'0-2-1-0/20 -OOoO() -0750 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />DEMOLISH <br /> <br />OTHER I <br /> <br />D BUILDING 1$ ,t; --; (; 0 / 0 b I <br /> <br />D ELECTRICAL 1$ I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I <br /> <br />D GAS ~ ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />111111.'...'.....,...,....................,..."."11''1'1111'..'.'.,."".".."'.....1111'1"111111"111111111'1'1,.'..'........................ <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />Address <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 />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />13( iJffeJ0.ktM4.h ~ tf;:; ~/ - L Y1 <br />I Y / N I FEE CURRENT -Y Y / N I <br /> <br />License # I U Loj-7 1.s-7 <br /> <br />Address <br /> <br />OTHER / ~ /;L <br />SIGNATURE /~V.c:7~ <br /> <br />Address If 2) Dr>>( 113'(( ...S Cot L-I. Itn J1 jL / '3 J> 7k <br /> <br />1I11111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I11I1111111111111111111111I11111111 <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 w/ 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 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 />111I111111111111111111111111111111111111111I11111I111111111111111111111111I111111111111111111111111111111111111I111111111I111111111111111111111111 <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 NC <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 />