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<br />813-780-0020 <br /> <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br />Owner's Name j <: <br /> <br />Owner's Address I .s-..s-.t.J L .Y.J41<l ~ ....,./1 VIr' c...../ iJ...-- <br />Fee Simple Titleholder Namel <br /> <br />JOB ADDRESS <br /> <br />Fee Simple Titleholder Address I <br />I Ss- 'I ~ 21 st-Sf- <br />I <br /> <br />WORK PROPOSED <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />2t'p hY',! tH' Us Fie.... 33.S4/ L LOT # <br /> <br />I PARCELlD#IJ2-.2'-2/'-00.z..0 - oof?OC?-O~2.0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />G:LJ ADD/ALT D SIGN D MOVE D <br />~ REPAIR <br />D COMM D <br />[2g FRAME D <br /> <br />SUBDIVISION <br /> <br />B <br /> <br />PROPOSED USE ~ <br />TYPE OF CONSTRUCTION D BLOCK <br /> <br />DESCRIPTION OF WORK I'Re FrClH1 <"- <br /> <br />BUILDING SIZE 1/8" DO I <br /> <br />'.....11...11....11..1.11..11........111..................................111....11....,11...11................,111.....111,......................11 <br /> <br />1$ II i 200. ClO <br />" <br />1$ <br /> <br />1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS ~ <br />FINISHED FLOOR ELEVATIONS I <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER I <br /> <br />roc.f- on <br />SQ FOOTAGE I <br /> <br />;:;'01"1 f J'O II".:-t...... <br />r <br /> <br />I <br /> <br />20(;-0 <br /> <br />of- n ec:....l y<e1 0 ..(l <br />HEIGHT I 20 I <br /> <br />D <br /> <br />BUILDING <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />o <br />D <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 />D <br />I <br />~~;~~~~"I 'il;; '&1' A,;s': ~1) ','" '~~;'~;"i ';f~;;~ '~;,>~ ~'~: ~";"""'''''' , <br /> <br /> <br />, <br /> <br />Address I License # I <: B 1151 w,~' <br /> <br />ROOFING <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />~D~/ <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />ELECTRICIAN <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 />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 />Address <br /> <br />I <br />I it) .(' ~() <br />~~..::... //L If).)' I <br /> <br />I S:S-Z.s- ...5'ou./A,...../lv.:,.,A/ .2)......., <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # I <br /> <br />1131"0 fht:"r's 'R~';,tJ /"'le- <br />I til N I FEE CURR~T I (j) N I <br />License # ICCC/3c2"9/tf <br /> <br />Address <br /> <br />11111111111111111111111 J 11111111111111111111111111111111111111111111111111111 J 1111111111111111111111111111111111111111111111111111111111111111111I <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 Safely 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 />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I111111I11 <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. (A1C 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 (Plot/Survey/Footage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br />