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<br />813-780-0020 <br /> <br />Dale Received <br /> <br /> <br />Owner's Name <br /> <br />City of Zephyrhills Permit Applicatio - k B-Z::V{ <br />Building Department i:Yf <br /> <br />Fax-813.780.0021 <br /> <br /> <br />SbI Nt l<::v ,;:'L. 3 397l{ <br /> <br />2<::-'1h~~.us, FL 33'5(('2.- LOT # l,qno <br /> <br />I PARCELlD#III-~'21- 0010- (V~c.?- O\tio <br />(OBTAINED FROM PROPERTY TAX NOnCE) <br /> <br />E3 <br />D <br />D BLOCK c:KJ <br />1 AiJ4 Ccm~L7rlt-J\ I..Je,.;DI <!.f::(? <br /> <br />I sa FOOTAGE I <br /> <br />1$.3/ t100 ~ <br /> <br />1$ <br />1$ <br />1$ <br />D <br /> <br />Owner's Address 15'2. -z:z... ~ S, <br />Fee Simple Titleholder Namll.ao~ c~ 57, ~.,..; <br /> <br />Fee Simple Titleholder Address I PoGo 'I.. ~:3J <br />15'2. '2- -z.. 871- c;;,-,- <br /> <br />1 <br /> <br />JOB ADDRESS <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />B <br />~ <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br /> <br /> BUILDING <br />D ELECTRICAL <br />D PLUMBING <br />D MECHANICAL <br />D GAS <br /> <br />ROOFING <br /> <br />FINISHED FLOOR ELEVATIONS I <br /> <br />~"r <br /> <br />-~Yl -(:)f3J.. <br /> <br />I <br />" <br /> <br />ADD/ALT <br />REPAIR <br /> <br />D <br />D <br />D <br />(2 ~Tf\ P <br />I <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />SIGN <br /> <br />I <br />D <br /> <br />COMM <br />FRAME <br /> <br />OTHER <br />STEEL <br /> <br />OTHER I <br /> <br />HE'GHT <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />:;c/c <br /> <br />AMP SERVICE <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />SPECIALTY D <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />FLOOD ZONE AREA <br /> <br /> I~Q~ k-~oA:.~ &C~ -;.rM- I \:i~ <br />BUILDER COMPANY 7i- <br />SIGNA TURE REGISTERED N FEE CURRENT N <br />Address J352/,'5 Sa. 64vJ Z -(..ht-l'> 3').jL{( License # leG<: 1508 ).'7?- I <br />ELECTRICIAN I I COMPANY I <br />SIGNA TURE REGISTERED ~ FEE CURRENT ~ <br />Address I License # I <br />PLUMBER I COMPANY 1 <br />SIGNA TURE REGISTERED Y/ N FEE CURRENT ~ <br />Address I License # I <br />MECHANICAL I COMPANY I <br />SIGNA TURE REGISTERED ~ FEE CURRENT ~ <br />Address I License # I <br />OTHER I COMPANY I <br />SIGNATURE REGISTERED ~ FEE CURRENT ~ <br />Address I License # I <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Pennit for new construction, <br />Minimum len (10) working days after submittal date. Required onsile, Construction Plans, Stonnwater Plans wi Silt Fence Installed, <br />Sanitary Facilities & 1 dumpster; Site Wor1< Pennit for subdivisions~arge projects <br />Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Fonns. R.O-W Pennit for new construction, <br />Minimum ten (10) working days after submittal date. Required onsile. Construction Plans, Stonnwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commerdal requirements must meet compliance <br />Attach (2) sets of Engineered Plans, <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />Directions: <br />Fill out applicalion completely. <br />Owner & Contractor sign back of application. notarized <br />If over $2500, a Nolice of Commencement is required. (AIC 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 <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (PloVSurveylFootage) <br />