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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 />.Wf)( IS <br />I I Lf <br /> <br />v <br /> <br />Date Received <br /> <br /> <br />Owner's Name <br /> <br />Owner Phone Number <br /> <br />r-rt;0'Ct.h:u.U~ J t..tn:: I <br />Owner Phone Number <br />SLI 4'l'1 <br />I Owner Phone Number I <br /> <br />Owner's Address tv 0 ~'k \od~ W '19 <8 ~ ~(p <br />Fee Simple Titleholder Namel <br /> <br />Fee Simple Titleholder Address I <br /> <br />!.J c, 9- ~ ~'1MCLX Ie.. A-l}O <br />ro-{CW'O ~(\'Z()(b I <br />rJ1 NEW CONSTR D ADD/ALT D <br />5J INSTALL D REPAIR <br />PROPOSED USE [KJ SFR D COMM D <br />TYPE OF CONSTRUCTION D BLOCK D FRAME D <br />DESCRIPTION OF WORK 1rY'1C'b'\'I~' \k-frY1e.-'rn~+v I~+-tcr(\ <br />I ?x') }.~) 3 I SQ FOOTAGE I ~5 "\ <br /> <br />1 (Plr)l()~1 i\s <br /> <br />PARCEL ID#I <br /> <br />3?J5G\) <br /> <br />LOT # <br /> <br />18d5 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />WORK PROPOSED <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER <br />STEEL <br /> <br />I <br />D <br /> <br />OTHER 1~11f'_ '~rrn(. <br /> <br />BUILDING SIZE <br /> <br />HEIGHT <br /> <br />D BUILDING 1$5;006 I VALUATION OF TOTAL CONSTRUCTION <br />D ELECTRICAL 1$ (000 I AMP SERVICE D PROGRESS ENERGY D WR.E.C. <br /> Alrt!--- <br />D PLUMBING l$loCYl I fJ/ <br />D MECHANICAL 1$/,500 I VALUATION OF MECHANICAL INSTALLATION <br />D GAS D ROOFING D SPECIALTY D OTHER <br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES c;tINO <br /> <br />..p.....II....."".II..II...II'.......II'IIIII....'.....'.'1.11"."11'.........111.....,111111..111...........111.......1111..................., <br /> <br />:~~~~~RE I fA;nS~,~f I <br />Address If)CI)~~~lD Yd\.1 (}.d. r2-lt, \\c:) ~~SL)d <br />~~;;:~~:N I ()JI:D ~~ I <br />Address IqQ3~)\'i\eJ'0()rtCi\ ~\Ld 0~.bm %glt <br />~~~~~E I ~ 6c~ I <br />Address 1~~~<6~J0CLU-~. ~I:h\\s ~SLjO <br /> <br />MECHANICAL I ( f) - Q ~.~!~ f'. r. I COMPANY <br />SIGNATURE tfJ..fX\,. X ~( )\ ~'--- REGISTERED <br />Address IYdB lA \ N\r fY'(xY:t\~t\(r~ <Yn <br /> <br />~~::TURE I I <br /> <br /> <br />Address I <br /> <br />COMPANY <br />REGISTERED <br /> <br />I \)t)61t L LC2- <br /> <br />I Y I N I FEE CURRENT <br /> <br />~CL <br />YI N I <br /> <br />FEE CURRENT <br /> <br />I Y IN I <br />[Jt(J ,~"1'35 <br /> <br />I YIN I <br />trH -OCX:O',Q4J <br />I <br />I <br />I <br />I Y IN I <br /> <br />ITH-~Lf I <br />I <br />I <br />I <br />I <br /> <br />I YIN I <br />I cS (y)OtfJ ~ I <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />~Cf -" <br />. Y/N <br /> <br />FEE CURRENT <br /> <br />License # <br /> <br />~% f=L~CURRENT <br /> <br />COMPANY <br />REGISTERED <br /> <br />License # <br /> <br />License # <br /> <br />COMPANY <br />REGISTERED <br /> <br />YI N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />License # <br /> <br />111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy FDrms; 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) cDmplete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new constructiDn. <br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Sift Fence installed, <br />Sanitary Facilities & 1 dumpster. Site WDrk Permit for all new projects. All commercial requirements must meet cDmpliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />'-"PROPERTY SURVEY required for all NEW constructiDn. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 II 11I11111111 j 111111111I11111 i <br />Directions: <br />Fill out application completely. <br />Owner & Contractor sign back of applicatiDn, notarized <br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) <br /> <br />Agent (for the cDntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same <br /> <br />OVER THE COUNTER PERMITTING (Front Df Application Only) <br />Reroofs Sewers Service Upgrades NC Fences (PlotlSurvey/FoDtage) <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br /> <br />--........_""'.~....,~ ....>.............~, <br /> <br />,',' ,~)~::':,,:~:~:.~'C :;~( fc4i, f <br /> <br />""'... . j,." . ,.".... '., '." ffffi,... <br />('l/i'...,-h _.'..,......-(..-;''.~.I.. ......:.,.,.. .'.-.<';' -' ";""'~'.-'...~".-...',';"",..'.'.;."';.-..: <br />.,--.", "..n,. '... :)'~T)H y'i~ ":-,:.~,-,,,"": <br /> <br />