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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />ictX-O 1 "'-/OV-UVL, <br /> <br />Date Received <br /> <br /> <br /> <br />~.19q(l <br /> <br />Owner's Name do...l'V\ ~ N Q..\ ~ y~ <br />Owner'sAddress I S~D t\\ rt.wblLn,,/ Z~'1~IIJ.s. <br />Fee Simple Titleholder Namel <br /> <br /> <br />Fee Simple Titleholder Address I <br /> <br />Owner Phone Number <br /> <br />:, >~), Own.. Phone Nurnh.. I <br />Owner Phone Number I <br /> <br /> <br />~ FL-') -$Nd- LOT # I <br /> <br />PARCELlD#1 iO-';)Jo - d-,l --ol~O -CX:X:)C:O-O~'70 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />o ADD/ALT D SIGNf'lD MOVE D <br />D REPAIR (Z.e -rOO' <br />D COMM D OTHER I <br />D FRAME D STEEL D <br /> <br />DESCRIPTION OF WORK I fje-vCi (J~ ;;l'-l 0() ~. ~ \ + 1L fJ Ii i- hDM JL. <br /> <br />BUILDING SIZE I SQ FOOTAGE I _0 _ _ HEIGHT I I <br /> <br />1111""""11"""111111""111111111"11"1111'1111111'1'1"'1""'1'1"1""11111111111111111""1111111""'1"""""'1111111'11""""'1'11 <br /> <br />o BUILDING ~ s. ,QQ I VALUATION OF TOTAL CONSTRUCTION <br /> <br />1$ I <br />1$ I <br />1$ I <br /> <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo <br /> <br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I11111111111111111111II11I111111111111111111111I111111111111111111I1111111111111I1111I1111 <br /> <br />JOB ADDRESS <br /> <br />S~J.o tvQWb~ <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />D <br />D <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />DEMOLISH <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />o <br />D <br />o <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />WR.E.C, <br /> <br />PLUMBING <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />YI N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y IN FEE CURRENT <br /> License # <br />YI N FEE CURRENT <br /> <br />Y/N <br /> <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br />I <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <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 /> <br />License # I <br /> <br />UCw('\VZ <br /> <br />FEE CURRENT ~ I <br /> <br />Y/N I <br />I c..cC{ ~:SS05 <br /> <br />OTHER <br />SIGN <br /> <br />Address <br /> <br />License # <br /> <br />RESIDENTIAL <br /> <br />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. Requiredonsite, Construction Plans, Stormwater Plans wI Slit Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslons/large projects <br />Attach (3) 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 onslle, Construction Plans, Stormwater Plans wI Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster. Slle 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 />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />1.1111111111111111111..11..11111111111111111.1111111.....11..11............11111.....1,1111...11..11..111111.1111111111111111111111...1111..111111 <br />DIrections: <br />FiIi 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 Fences (PloUSurvey/Footage) <br /> <br />Driveways-Not over Counter If on public roadways..needs ROW <br />