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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 />Date Received
<br />.
<br />
<br />
<br />V<;wner's Address '3 ~ 0 4 ~
<br />Fee Simple Titleholder Nam~
<br />
<br />\O~ Au€-
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />t/' Owner's Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />V'JOB ADDRESS
<br />
<br />~c;o Y. <:?
<br />
<br />( ()-tY\
<br />
<br />A \.j f?-
<br />I PARCEL ID# I
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />I d-. -~lo-d \ -00'10_ r::xx:oo _ 0030
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />o
<br />o
<br />I (2e 'OD~
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />o
<br />D
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I
<br />
<br />,..,",...."...,...."...,....,...".,..."..........."....,..".....,......,....,...........,.,..:..,..,....,....."""........,..............
<br />
<br />0 BUILDING 1$ ~0D.OO I VALUATION OF TOTAL CONSTRUCTION
<br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 W.R.E.C.
<br />0 PLUMBING 1$ 1
<br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />0 GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />",..,',....",.....,.."...,....,.,.."......,.,..,......,.."...,.,.......,..."............,.....",........".'.'.....'..""."."".."'.,.,
<br />
<br />BUILDER j' C\ /) J
<br />SIGNATURE ;fCVvt.uL
<br />
<br />Address _
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />'iY~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />14--~ (JL9..FY\.L.^-
<br />I Y I N I FEE CURRENT
<br />
<br />License # I
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />RESIDENTIAL
<br />
<br />11'11""1"1'1111111"'11'1"11'1'11'1111'1'11'1"1'1111'11"11111'11'111'11111'1"1111111111'11'11'1'11'11'1'111'1"11"""'1'11'111111111"111
<br />
<br />COMMERCIAL
<br />
<br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />SIGN PERMIT
<br />
<br />111.1111,111111111,111111111,11,11.1.1111.1.,1,1.1111.1..11.1..11.1..1.1.11.1,11.11.11.,1111.1,11111,1111,1111111.II,IIIIIIIIIIIIIlli.II.lllllllli
<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 Driveways Fences (PloUSurvey/Footage)
<br />
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