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<br />\ . <br /> <br />~ 13-78G-0020 <br /> <br />City of Zephyrhills Permit Application <br />Building Department <br /> <br />Fax-813-78G-0021 <br /> <br />Date Received <br /> <br /> <br />#71/5 <br /> <br />Owner's Name <br /> <br />Ownef's Address I Do ~ oX ?F561 0 <br />Fee Slmpte TItleholder Name I <br /> <br />r <br />LOU\ s\rd,\f', 'l t <br />. <br /> <br />I <br /> <br />I <br />I <br />I <br />B\vd. UJrn\/rh\\\S 33SLt21 LOT' I I <br />PARCELIDtI02- 210 - 2-1 -(\() \0 - 05(000 -OcDIO <br />(OBTAINED FROM PROPERTY TAX NOlICE) <br />o SIGN 0 MOVE 0 <br /> <br />o OTHER I <br />o STEEL 0 OTHER J <br /> <br />Owner Phone Number <br /> <br />Owner Phone Nmnber I <br />Owner Phone Number I <br /> <br />JOB ADDRESS <br /> <br />Fee Simple TItleh0Ider Address I <br /> <br />I ( n5L\ S <br />I <br /> <br />G-oJ\ <br /> <br />DESCRIPTION OF WORK <br /> <br />B <br />o <br />o BLOCK <br />I (UJ-foDi:.L <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br /> <br />I <br />E:f <br />l8J <br />o <br /> <br />ADDlALT <br />REPAIR <br />COMM <br />FRAME <br /> <br />DEMOLISH <br /> <br />SUBDIVISION <br /> <br />WORK PROPOSED <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUcnON <br /> <br />BUILDING SIZE <br /> <br />(,J'f/!;flI... n- - <br />SQ FOOTAGE I <br /> <br />,AJJr) p~~ f F~y€re <br />~SO () I HEIGHT I <br /> <br />" '"'' , " , " . . . <br /> <br /> <br />o BUILDING 1$ <br />o ELECTRICAL 1$ <br />o PLUMBING 1$ <br />o MECHANICAL 1$ <br /> <br />o GAS 0 <br />FINISHED FLOOR ELEVATIONS I <br /> <br />ROOFING <br /> <br />l-rt1f"t~LUATION OF TOTAL CONSTRUCTION <br />AMP SERVICE 0 PROGRESS ENERGY D W.R.E-C. <br /> <br /> <br />VALUATION OF MECHANICALIHSTAUATION CD ~ DV c L <br />S~~I.. <br /> <br />SPECIALTY 0 <br />FLOOD ZONE AREA <br /> <br />OTHER <br /> <br />'-13, j) 0 Q <br />~,O()Q <br /> <br />I \,)\:.10 <br />I <br /> <br />Il DOO <br />I <br /> <br />DYES <br /> <br /> <br />1~~,~~~tr;D??IN~~~~:Y <br /> <br />~ CLr'\ Urense' I C (2L Ol on '2 F) 2 I <br /> <br />. ~=;R: lSpyl(mt~sL~~Ytrrn0k1 <br /> <br />~- <J'?;O-(,9J?,'}. Lirense' IC~G-CJ60 (o~ill <br /> <br />\\) COMPANY I Sb{,J (l.6ILL'( rWJ'lt$(,J c> '" <br />REGISTERED I Y I N I FEE CURRENT I Y I N I <br />Urense' ICF~oS7tt7 2 I <br />I <br />I <br />I <br />I <br /> <br />COMPANY <br />REGISTERED <br /> <br />Y/N <br /> <br />FEE CURRENT <br /> <br />Y/N <br /> <br />BUILDER <br />SIGNATUR <br /> <br />\....tfLUMBER <br />SIGNATURE <br /> <br />~HANlCAL <br />SIGNATURE <br /> <br />Address <br /> <br />Urense . <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 />Lirense . <br /> <br />RESIDENTIAL <br /> <br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Pennit for new construction, <br />Minimum ten (10) wor1dng days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Wortt Permit for subdivisionsllarg projects <br />AItach (3) campIete sets of Building Plana plus a Life Safety Page; (1) set of Energy Forms. R-Q-W Pennit for new construction, <br />Minimum ten (10) wortdng days after submittal date. Required onsite, Construction Plans, StoomJ8ler Plans wi Silt Fence installed, <br />Sanitary Faalities & 1 dumpster. Site Wortt Permit for all new projecls. All commercial requirements must meet compliance <br />Attach (2) sets of Engineered Plans. <br />-PROPERTY SURVEY required for an NEW constnJc:tion. <br /> <br />COMMERCIAL <br /> <br />SIGN PERMIT <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 Servire Upgrades AIC Fences (PIotISurveylFootage) <br />Driveways-Not over Cotmter if on public roadways,.needs ROW <br />