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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 />Owner Phone Number
<br />
<br />nu V ~ \r .
<br />Owner'sAddress I/alo03 ~ H ,LL~ fA. R\V-e'-\I\~--A3.3.5z%wnerPhone Number 16 7/-.)9 ~.-S
<br />Fee Simple Titleholder Nam~ I Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />! 3<6'Sdd
<br />1
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<br />QIC 5Y:
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<br />SUBDIVISION
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<br />PARCEL ID#/
<br />
<br />LOT# /
<br />
<br />I
<br />
<br />B NEW CONSTR B ADD/ALT 0
<br />INSTALL REPAIR
<br />PROPOSED USE 0 SFR D COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
<br />
<br />DESCRIPTION OF WORK I ~ l\ l (')lY\: e l'-t c.. ~, (' c I
<br />
<br />BUILDING SIZE I I So FOOTAGE I I HEIGHT! I
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<br />',....."...,.,..........,...."...,."...,.".........,....,.......,....."............"....,..,.. ...,.,.,.,........".,.,...,.....,..".""'1
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<br />o BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
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<br />1$ ~O rri;6 0 I
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<br />o PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />o GAS 0 ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />WORK PROPOSED
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />I
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />I....".....,......,........,.,..........,.,..,..,....",....,....,.............,.,..........",........,..,.,..,........,',.."".....,.."",."
<br />
<br />I
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address 1
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br />License # I
<br />
<br />lQ~ () u[' l;-J.oC~' Co
<br />" (.....Y / N I FEE CURRENT I
<br />
<br />License # I
<br />
<br />Y/N
<br />
<br />1
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Address
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER l'
<br />
<br />SIGNATURE .
<br />
<br />Address ~....,.......
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> LIcense #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI 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 />RESIDENTIAL
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<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 onsile, 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />111.1,..1,1,..,1,11,1.1,1.1,11111.1.11.1.11.11.1,11.1.1,1.1.1,111.1.1.11.1.11.1.11111.1,1.111.11,111.1.1.111I. I. Iii II. I. III I,ll I. 11I11 I. 11111 III Ii
<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. CAlC 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 A1C Driveways Fences (PloUSurvey/Foolage)
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