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<br />813-780-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />tr0J(3 <br /> <br />Fax-813-780-0021 <br /> <br />Date Received <br /> <br /> <br /> <br />'( \'0 Sf- Owner Phone Number <br /> <br />CA q5s$3~1~~ Phone Number I <br /> <br /> <br />I Owner Phone Number I <br /> <br />Owner's Name ~~a~h-- ,Asse+ tod<ed c..~C <br />Owner's Address I P.o ~)( 131 ( to., Sac...n:,i.rT\p nn <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />13~q5t-4 <br />I <br /> <br />~-th <br />I <br /> <br />A\Je <br /> <br />PARCEL 10#114-2.(0 -,.2-\ - 00\0' 00 \ 00 -00\0 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN D MOVE D <br /> <br />LOT # <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />D <br /> <br />D <br />D <br />r rcy.>1oLe -teed~ J%.. <br /> <br />I HEIGHT I <br /> <br />DEMOLISH <br /> <br />BUILDING SIZE I <br />I " I I I . . , I I . , . . I I I I . . . I I . . . I I . ~ . I I . 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I r I I I . . <br /> <br />~ <br />D <br />IJDs-tO,\\ <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />0....---- ADD/AL T <br />OZJ REPAIR <br />o COMM <br />o FRAME <br /> <br />(1Q W cf\ere- I-D 'K <br /> <br />SQ FOOTAGE I <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />OTHER I <br /> <br />DESCRIPTION OF WORK <br /> <br />: ~ BUILDING <br />ELECTRICAL <br /> <br />1$ <br />rl5< ese-) <br />D PLUMBING 1$ <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I <br />I <br />I <br />I <br />o <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE r ro 0 <br /> <br />PROGRESS ENERGY <br /> <br />o <br /> <br />WR.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />ROOFING <br /> <br />SPECIALTY D OTHER <br />FLOOD ZONE AREA DYES <br /> <br />ONO <br /> <br />11"1,111,.,111"'1."...111"11"'111'...1..."1111'..1.1"'1'1'1111"'.1'1,...."1""111'1'..'.1"11'1'111'1'..'....'....1'.'."'...'1....'..., <br /> <br />Address <br /> <br /> <br /> <br />BUILDER <br />SIGNATURE <br /> <br />Y/ N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />'6, S(O.\.} <br />, <br /> <br />rL <br /> <br />i-Ol- <br /> <br />~l <br />I <br /> <br />License # I <br /> <br />COMPANY I ~umore'5 Elec-tr~ wi <br />REGISTERED I Y / N I FEE CURRENT I Y / N <br /> <br />3 4'-0 $q License # I <br /> <br />COMPANY I <br />REGISTERED Y / N FEE CURRENT Y / N <br /> <br />ELECTRICIAN <br />SIGNATURE <br />Address 3'68Q <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />Address <br /> <br />License # <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 />11I111111111111 1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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 />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111I <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 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 />