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<br />813- 780-0020 <br /> <br />:P 5?(P1 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br /> <br />Date Received <br /> <br />Owner's Name K:f/o::.v/VA,N/"It?J <br />Owner's Address I '5"13<1 BectV/M..o",-f Av~ ;141M.~ <br />Fee Simple Titleholder Name I <br /> <br />Fax-813-780-0021 <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />Fee Simple Titleholder Address I <br /> <br />I g6oS's S'H1HJY BI-vPF U,O? 2€pH-'1I2H"(uS, Fe- 3S's,tfd <br />1 ~L VElZAOo AAwLt-/ <br /> <br />JOB ADDRESS <br /> <br />LOT # <br /> <br />1'1 <br /> <br />SUBDIVISION <br /> <br />PARCELlD#1 "'f Zf, Z( OOC::.O OCJ2.oc> 00 'to <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />BUILDING SIZE <br /> <br />2.<::>~ (C> <br /> <br />1 <br /> <br />B <br />D <br />D <br />fba~ t-I <br /> <br />SQ FOOTAGE I <br /> <br />FRAME <br /> <br />WORK PROPOSED <br /> <br />[g <br />D <br />D <br />I :X-fZEeJ <br />I <br /> <br />ADD/AL T D <br />REPAIR <br />D OTHER I <br />D STEEL D <br /> <br />~ .4/c-N"1 i VI U ""'" ~ V\ ~ <br /> <br />'Z ~O I HEIGHT Ii:}" <br /> <br />NEW CONSTR <br />INSTALL <br /> <br />SFR <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />COMM <br /> <br />BLOCK <br /> <br />DESCRIPTION OF WORK <br /> <br />SIGN <br /> <br />D <br /> <br />DEMOLISH <br /> <br />MOVE D <br /> <br />OTHER I 4t.v#f,f' A/vJ>'l- <br /> <br />D BUILDING 1$ '2 Z~.~:::> <br />D ELECTRICAL 1$ ,~ <br />D PLUMBING 1$ ~ <br />D MECHANICAL 1$ ~ <br />D GAS D ROOFING <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />WR.E.C. <br /> <br />D <br /> <br />D <br /> <br />PROGRESS ENERGY <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />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 subdivisionsllarge projects <br />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 />Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />17 <br /> <br />[ <br /> <br />BUILDER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />ELECTRICIAN <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />PLUMBER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br />MECHANICAL <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Address <br /> <br /> <br />OTHER <br />SIGNATURE <br /> <br />~ p:1, <br />3f1Fb t/.S.19 <br /> <br />Address <br /> <br />RESIDENTIAL <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <br /> <br />OTHER <br />DYES <br /> <br />DNO <br /> <br />1m <br /> <br />- <br /> <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y / N FEE CURRENT <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br /> <br />License # I <br /> <br />I L.II-'?;;T/ ME: /!t...u"" lA/v,., <br />If Y) N I FEE CURRENT l{'YjN I <br /> <br />License # I /<X t!'J (;) ~ ~ t{ S"-I <br /> <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 AlC <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />Fences (Plot/Survey/Footage) <br />