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<br />813-780-0020 <br /> <br />Date Received <br /> <br /> <br />City of Zephyrhills Permit Application Lb~' o~ 1 <br />Building Department ..".. I) <br /> <br />Fax-813-780-0021 <br /> <br /> <br />Owner's Name hG\.... <br />Owner's Address I ":;, ~ ot ~ <br />Fee Simple Titleholder Namel <br /> <br />~ ~y <br />W D ~ C()..o f1 JC:r:.& <br /> <br />Owner Phone Number <br />'"> 'U""f.{ "2..- <br />~1J. (/l1wn" Phone Numbe, I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address <br /> <br /> <br />B <br /> <br />PROPOSED USE D <br />TYPE OF CONSTRUCTION D <br /> <br />DESCRIPTION OF WORK I R~-'rn(lf <br /> <br />I <br /> <br />I I . . I I . . . I I r , , . . I I . . . ., I. . I I . . , . I . . I I . . . I . I I I I , . I I I . . I I I . . . I I . . . I I I . . . I I I . . . I I I . . . I I I . . . . I I . . I I . I I . . ..' I I I . . , , . . . . I I , , , r I , I r , I , I , . . . . . . . . . . . . . I r . . . , <br /> <br />1$ L-\"<3 cO . <br />1$ <br />1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS t8r <br />FINISHED FLOOR ELEVATIONS I <br /> <br />B <br />D <br />D <br />- 21, l~es <br />SQFOOTAGEI. crJ <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />BUILDING SIZE <br /> <br />D <br />D <br />D <br /> <br />BUILDING <br /> <br />ELECTRICAL <br /> <br />PLUMBING <br /> <br />ROOFING <br /> <br />LOT # <br /> <br />Ic::;(~ <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />- Oca:xJ- OZ 8C) <br />(OBTAINED FROM PROPERTY TAX NOT/CE) <br />D SIGN D MOVE D <br />(<. oo-fl- <br />D OTHER <br />D STEEL <br /> <br />DEMOLISH <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />HEIGHT I <br /> <br />~I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />I <br />I <br />I <br />D <br />I <br /> <br />D <br /> <br />D <br /> <br />AMP SERVICE <br /> <br />PROGRESS ENERGY <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 />.11111.....'.,""..11111111...11..11'."'.111'.'.,'"111111"'11111..."11'."""""".."...'11"11"1'......lllflll.....IIIIIII'."'IIIIII.,1 <br /> <br />BUILDER COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N <br />Address License # <br />ELECTRICIAN I COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N <br />Address I License # <br />PLUMBER I COMPANY <br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N <br />Address I License # <br />MECHANICAL I COMPANY <br />SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br />Address License # I <br />OTHER ~M~ ROJi'~ ~ <br /> Y / N FEE CURRE I Y/N I <br />Address >>St.{'V License # ICcc I ~ 5 <;OS <br /> <br /> <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 />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 w/ 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 />1111111111111/1111111/111111111/11111111111111111111111111111111111111111111111111111I11111111111111111111111/11/11/11/11/1//1111111111/1111111111 <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 t1-,e contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing s.:'\me <br /> <br />OVER THE COUNTER PERMiTTING (Front of Application Only) <br />Reroofs .,Sewers Service Upgrades AlC <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (Plot/Survey/Footage) <br />