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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 /> <br /> <br />l\ - '1-0 <br /> <br />Owner's Name :5'7 i L (J e fZ,J: lJ 0 L-L- <br /> <br />Owner's Address I Z 5 0 (, I.), 'Kou '-j ? 01 f) "( 7)/2 ! {/p I Owner Phone Number I <br />/A1i?A- 1Ft., 33 6&7 I S/. J i/P:;::. 17 L", ;") 'J? I I <br />Fee Simple Titleholder Name v v v-/~...-"\ V (/ L c..- Owner Phone Number <br /> <br />Fee Simple Titleholder Address 11'S-t:?2/J f2c:ck1 PO/t7f ))j2fJ//3 i Ullf?A I Fi. '3 ']607 <br /> <br />~~D:~~~ !J(/~cr C; ,rf-po 7};,4Ll' H . 51ctv U"/V/~'?{/;/}yJ~' 1: ~{~" lOT# I I <br />6v1J:> <br />I~ ef~fZPt>b >iLJI5/CAPf) I PARCEL ID# ?ifMP / A ~-+T ~T &~ 61 f1cH=7 <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br />SIGN C!1' MOVE D <br /> <br />Date Received <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />~ <br /> <br />D <br />G" BLOCK D <br /> <br />I ~C;2- Sl~ <br /> <br />ISQ FOOTAGE I <br /> <br />1,......,"....11,.......11...11.......111..........111...111....11.11.......1..........111.......111...111..,.........1111.........,.....11....111 <br /> <br />I I U <br />HEIGHT -2. 't "CJ <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />t,'....'III"t'"III..."'"IIII'..."I""..,.....,.I'I",1..11"...'1""'.....'1'.'"11""111."..111..'1".11..,'.'..'1""1.'11".......'1....... <br /> <br /> <br />:~~~~~RE I @;~!L 21~.'~~~ I <br />Address 39'1~l CIs /fteJY Ie; JJ. ,TA/??av glf2tlkJ! /,t(. S~~I <br />'1';-' ,..:1'> I COMPANY I <br />. REGISTERED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />B <br />D <br /> <br />ADD/ALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />D <br />D <br />D <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />cz:J <br /> <br />1$ j OJ 000. (fl0 <br /> <br />1$ <br /> <br />1$ <br /> <br />1$ <br /> <br />c=J GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />BUILDING <br /> <br />Owner Phone Number ? J 3 - 2 gg / f3 0 78 <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I <br /> <br />ELECTRICAL <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br />D <br />D <br /> <br />PLUMBING <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C. <br /> <br />OTHER <br /> <br />_ L~!A~. <br />_ €..\ec\-tlo(\n -S\~ <br />- Noc.. <br />\ \ 12\ laD - NohGed. (MxJ~ <br /> <br />DNO <br /> <br />MECHANICAL <br /> <br />VALUATION OF MECHANICAL INSTALLATION <br /> <br />Address <br /> <br />111111111111111 I111I11111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111 <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) 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 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 />III frnlllnl J J 1111111111111111111 Jill J J 1111111111111111111111111111111111111111111111111111111I11 J 11I11 J 11111111111111 J 11111111111111111111111111 <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 (PloVSurvey/Footage) <br /> <br />SPECIAL TV D <br />FLOOD ZONE AREA <br /> <br />ROOFING <br /> <br />COMPANY <br />REGISTERED <br /> <br />ELECTRICIAN <br />SIGNATURE <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 />OTHER <br />SIGNATURE <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />DYES <br /> <br /> <br /> <br />TJ2AeI1V/r ct-/2CQ P . IDe <br />{ . <br />FEE CURRENT Y I N <br /> <br />I ("tiC OS"! / S-s <br /> <br />License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br />Y/N FEE CURRENT <br /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y/N <br />