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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Owner's Address <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br />'7Drl <br />5+1 <br /> <br />Owner's Name <br /> <br /> <br />1-;1.3-0 <br />~tf"r~ <br />502'1 <br /> <br />Date Received <br /> <br />WORK PROPOSED <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />7?O-<g5~ <br />3' J 2-j03dJ <br />I <br />I <br />I LOT# I I <br />PARCELlD#I/2-2b- 2 ( -01 ~O -()OOOO-o6~O <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />D SIGN D MOVE 0 <br /> <br />o <br />o <br /> <br />Fee Simple Titleholder Address I <br /> <br />502Lf ZO 1Jz 51, <br />S ~Y"f/ YJ\U' J...;) /1 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />D <br />G1 <br /> <br />o <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION [0 <br /> <br />DESCRIPTION OF WORK I g 4 t' cv;} e.. <br /> <br />I 301 X 211 r SQFOOTAGEI bOO HEIGHT I Ilj I <br /> <br />.-".11.....11.1111...'"'.......'....11....1111...11...111...11'....'.....1111....11.....,.....11...'.111.11..........111.....11111111.111'11111.11 <br /> <br />1$ /6) {){Jo, -- <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />D GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />B <br />D <br />D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />BUILDING SIZE <br /> <br />ROOFING <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />W.R.E.C <br /> <br />[ZJ <br />G6 <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />ELECTRICAL <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLA <br /> <br /> <br />PLUMBING <br /> <br />SPECIALTY 0 <br /> <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />Ir...PII""III..'III'III....,.,III"'I'II'...IIIIIIII"..11"'.'111..""1111111"11111"11111"'..11111111Ilr.IIII'......'II...'II'......."..11 <br /> <br />COMPANY f1~Me- () WI1.p~ <br />REGISTERED I Y I N I FEE CURRENT <br /> <br />License # I <br /> <br />;~:~~~~ Lit rrr-~! <br /> <br /> <br />License # I <br /> <br />':~~~~RE I f~ ~ <br /> <br /> <br />Address I <br /> <br />EL~CTRICIAN I.. ./ jJ,-1.. /' I a t/d I~ A A~I <br />SIGNATURE ~I t:U-~ (~g"n - - <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Address <br /> <br />COMPANY <br />REGISTERED <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Y I N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />OTHER <br />SIGNATURE <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />Address <br /> <br />License # <br /> <br />1I11111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111I111111111I11111111111111111111111 <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 />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.' . "''It~... 'i" --.,..;. .. ... ... <br />11I1111I1111I11111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIJ 1111111) III L 11'111111111'1 i 11'1'1 fi i-I ;"1111111111111111111111111111 <br />Directions: "\~~ly~,}., \\,'. ..'t"". ..~'-' ..Il ~,~ <br />Fill out application completely. \.., ..>\.., \ """';.t-. <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 lettet{rom ~~r autflorizing s~me <br /> <br />OVER THE COUNTER PERMITTING (Front of Application Only) '- ')"~ <br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage) <br /> <br />COMMERCIAL <br /> <br />'. 'h\\\ \.~ <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />