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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 /> <br />Date Received - Z 1- -() <br /> <br />Owner's Name LTtL/Jel- 0" /J1/Y- J; <br />Owner'sAddress I ~()o-7 A(;je~ /J/'Jte <br />Fee Simple Titleholder Namel <br /> <br />Owner Phone Number <br /> <br />Owner Phone Number I <br /> <br />Owner Phone Number I <br /> <br />,(J/'. <br /> <br />Fee Simple Titleholder Address <br /> <br />JOB ADDRESS <br /> <br />tJ do 7 <br />z~f4r <br /> <br />UrtelU1l/ <br />..., J <br /> <br />z e~41' t-/ II . f(. .33JT/d- LOT # I s</ <br />PARCELlD#\ {)3 - olb-J/- 0/3d -(XJJ:JJ- cJS9'O <br /> <br />SUBDIVISION <br /> <br />I <br /> <br />B <br />D <br />[$J <br />S C /' an room (J/J <br />sa FOOTAGE I <br /> <br />D <br />D <br />D <br />tuaJcl ck~ <br />r;lJt I <br /> <br />IU~ <br /> <br />WORK PROPOSED <br /> <br />t8 <br />~ <br />I <br /> <br />NEW CONSTR <br />INSTALL <br />SFR <br />BLOCK <br /> <br />ADD/AL T <br />REPAIR <br />COMM <br />FRAME <br /> <br />PROPOSED USE <br />TYPE OF CONSTRUCTION <br /> <br />DESCRIPTION OF WORK <br /> <br />BUILDING SIZE <br /> <br />f' f >{. it <br /> <br />1$ L.I o:J <br />. 7, 0020. <br /> <br />o ELECTRICAL 1$ <br /> <br />D PLUMBING 1$ <br /> <br />D MECHANICAL 1$ <br /> <br />D GAS D <br />FINISHED FLOOR ELEVATIONS I <br /> <br />I <br />I <br />I <br />I <br />D <br />I <br /> <br />SPECIALTY D <br />FLOOD ZONE AREA <br /> <br />BUILDING <br /> <br />(OBTAINED FROM PROPERTY TAX NOTICE) <br /> <br />SIGN <br /> <br />D <br /> <br />MOVE D <br /> <br />DEMOLISH <br /> <br />OTHER I <br />STEEL D <br /> <br />OTHER I a...Iu/fl///!//J1 <br /> <br />HEIGHT <br /> <br />AMP SERVICE <br /> <br />VALUATION OF TOTAL CONSTRUCTION <br /> <br />PROGRESS ENERGY <br /> <br />D <br /> <br />D <br /> <br />W.R.E.C <br /> <br />VALUATION OF MECHANICAL INSTALLATION '- ""is ;~;:;~~~~AVICE <br />- "Xi -066-824-7894 <br /> <br />Address <br /> <br />MECHANICAL I <br />SIGNATURE . <br /> <br />Address I <br /> <br />OTHER I <br />SIGNATURE <br /> <br />Address I <br /> <br />1111111111111111111111111111111 " 111111 " 1111 " " 11111111 " III " 1111 " 11111 " 1111 " 11111 " III " 111111 " I " I " I111111111111111111111111111111111111 <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 w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects <br />COMMERCIAL 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 on site. Construction Plans, Stormwater Plans w/ Silt Fence installed, <br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must nieet compliance <br />SIGN PERMIT Attach (2) sets of Engineered Plans. <br />....PROPERTY SURVEY required for all NEW construction. <br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <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. (A1C 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 A/C Fences (Plol/Survey/Footage) <br /> <br />ROOFING <br /> <br />BUILDER <br />SIGNATURE <br /> <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 />COMPANY <br />REGISTERED <br /> <br />COMPANY <br />REGISTERED <br /> <br />Driveways-Not over Counter if on public roadways..needs ROW <br /> <br />OTHER <br /> <br />DYES <br /> <br />DNO <br /> <br />4/an-. ~~ . <br />FEE CURRENT I Y / N I <br />License # I <br /> <br />~cJJ /LJ <br />I Y / N I <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 /> License # <br /> <br />Y/N <br /> <br />Y/N <br /> <br />Y /N I. <br /> <br />Y/N <br />