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<br />Date 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 />Owner's Name J <br /> <br />Owner's Address 8'J<l I.>,S <br />Fee Simple Titleholder Namel <br /> <br />f'h <br />0"..).,.. t.:d~ <br />3 J $:J <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br /> <br />17lf35 0'411 <br />I <br /> <br />11/ () D <br /> <br />2-r:p^~,..J..,/JJ Fi. <br />I PARCEL 10#1 <br /> <br />B <br />D <br />D <br /> <br />3 3ScJ / <br /> <br />LOT # <br /> <br />SUBDIVISION <br /> <br />DESCRIPTION OF WORK <br /> <br />tE <br />D <br />D <br />-:r ..... s 1,,-1/ <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />AD DIAL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />BUILDING SIZE <br /> <br />I /1' K JO' '-/ II <br />SQ FOOTAGE I II A . " S <br /> <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER <br />STEEL <br /> <br />OTHER [ <br /> <br />/I <br /> <br />1"....11.........111.'.,11111".1111.1111.11..,11,...,....,1,....,11....,111....111....,11....,..........,1.,........,...11...............'.1111. <br /> <br />1$ J-1(JO.W I <br /> <br />~ ELECTRICAL 1$ 10f). v-l' I <br /> <br />D PLUMBING 1$ I <br /> <br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION A JOCJ pz.~ <br />IVI , ~ <br />D GAS D ROOFING D SPECIALTY D OTHER lsv~ <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO <br /> <br /> <br />.....'.1...'.....1.1.1.".........1....'..1"'..11111111'111.'1.'.'....,.,..,..'....111111111...'......,..,..lr........IIII"..I'..'....I......... <br /> <br />D <br /> <br />BUILDING <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 />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />ELECTRICIA <br />SIGNATURE <br /> <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />(. D 51&;J '"C rvt...e..:J:1.-1L <br />I Y I N FEE CURRENT I Y I N I <br /> <br />License # I CC /3 cKJ 51 ) D <br /> <br />FL 3if6 <br /> <br />I <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE <br /> <br />License # <br /> <br />Address <br /> <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y I N FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br />FEE CURRENT <br /> <br /> <br />Address License # I Fe /3 c/O") I )'D <br /> <br />11111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I111111111111111 <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 subdivisionsllarge 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 />1111111111111111111111111111111I111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111 <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. (Ale 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 (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />