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<br />813-780-00~ <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />, . Fax-813-780-0021 <br /> <br /> <br />SDVV <br /> <br />Phone Cootactfol Penol.'ng ",.. h, ,I,.....,..... .l;;>,""'" " <br /> <br />Owner Phone Number :Js:J ~ 'Z.. () " .- 45$ I <br /> <br /> <br />Owner Phone Number 11' / 3 ~ 7 8' ~. :5 ,( 3 I <br />Owner Phone Number I I <br />I <br />I <br />I <br /> <br />...--- <br />Owner.s Name 'J..( r ~ VA ;' " <br /> <br />Owner's Address I ~ <br /> <br />Fee Simple Titleholder Namel <br /> <br /> <br /> <br />· Date Received <br /> <br />.J~ Z b <br /> <br />e/ <br />&..// IJ"/:/, <br /> <br />Fee Simple Titleholder Address <br />5'OZ(.. <br /> <br />JOB ADDRESS <br /> <br />6--t:L/1 <br /> <br />!Jllle/. ~/'yy4111; rL <br /> <br />, <br /> <br />I PARCEL 10#\ <br /> <br />E3 <br />D <br />D <br />:2 j;;e? I /a-? 1-5- <br />I ''\/\00 <br />sa FOOTAGE c7V <br /> <br />J'J.J;'1Z <br /> <br />LOT# I <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN CJ MOVE 0 <br /> <br />DEMOLISH <br /> <br />WORK PROPOSED <br /> <br />B <br /> <br />PROPOSED USE 0 <br />TYPE OF CONSTRUCTION 0 <br /> <br />DESCRIPTION OF WORK 1.2 "5 rC / / <br /> <br />I I <br /> <br />,.,..11............111....11.11...111.....111..........III..IIII....I.I...'.III...............II.I......I~II..11......111...11...,...........1...... <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />o <br />~ <br />o <br /> <br />. f:1 <br />OTHER I ~/.~...h-,~'~ Ii,,, <br />STEEL D OTHER I <br /> <br />-A v ~ (',~ ;::ve/ <br /> <br />;;.~ / I p"'{- os <br /> <br />HEIGHT [ <br /> <br />BUILDING SIZE <br /> <br />D BUILDING 1$ <br /> <br />D ELECTRICAL 1$ <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />BUILDER <br />SIGNATURE <br /> <br />AMP SERVICE . ~ PROGRESS ENERGY 0 W.R.E.C <br />f.-5-ltf,'d ~w171U.jfUffl~:e.CV~J _~,,'~~~ <br />~.~~~~~~6i7 ~y~- <br /> <br />VALUATIONOFMECHANICALINST;~~~.N~:~ #z4'"." ~~: <br /> <br />D SPECIALTY 0 OTHER . (.p~~.f."" ~t{7~. /'/.~ . <br />I FLOOD ZONE AREA DYES OJ'D ~ ~ '1 _"_ <br /> <br /> <br />I~~I <br /> <br />ROOFING <br /> <br />COMPANY <br />REGISTERED <br /> <br /> <br /> <br />License # <br /> <br />l ~~t-~.- <\:;flW~ <br />=r1/ w-r~:~r~~;rR~NT i Y / N i <br />License # IN: &.::.: " f ~ <br />I ~~~1 ~~~~:/~1)N I <br /> <br />License # Il::L1300 It 4 I <br /> <br />MECHANICAL <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 />OTHER <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 />111111111111111 1111111111111111111111111111111111111111111111111111111I1111111I1111111I111111111111111111II11I111111I1111111111111111111111111111 <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 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 onslte, 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I111111111111111111111111111111111111I <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of application, notarized <br />If over $2500, a No~ce of Commencement is required. (AlC upgrades over $5000) <br /> <br />Agent (for the cql'tractor) 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 />