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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 />Ode:! (onclo I!S5'oC
<br />138333 (6-/101') ~d f/
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder NamJ
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />/38'"35'1
<br />I
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />kn lA/cJ 0/ ;11
<br />I
<br />B
<br />o
<br />o
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />o
<br />o
<br />
<br />LOT #
<br />
<br />PARCEL ID#102.. -lb -7...1 - 0"2..( tI-OCMoa - 00/ 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />SUBDIVISION
<br />
<br />DESCRIPTION OF WORK v- 0 D f U.s ~ e..<:t. v ( '(
<br />
<br />BUILDING SIZE I I SQ FOOTAGE ~ oD HEIGHT I I
<br />
<br />,..,',..,..,........."...,.,.,......"...,................,........."......,.....,...",..,.......:..."..,......"..,.......".,..,.."."..",
<br />
<br />o BUILDING 1$ /~ p-s-GJ I VALUATION OF TOTAL CONSTRUCTION 1/0; ~;-O
<br />
<br />o ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
<br />
<br />o PLUMBING 1$ I
<br />
<br />o MECHANICAL r I VALUATION OF MECHANICAL INSTALLATION
<br />
<br />o GAS ~-ROOFING D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />rO 0 f'
<br />OTHER I
<br />
<br />
<br />tc-.-b
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />..,..."...."....,...."........,...."........,....,..,....,....,.,..........."................,...,........,',........,',..,..,..,.....,..,..,
<br />
<br />BUILDER COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT
<br />Address License #
<br />ELECTRICIAN I COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT
<br />Address I License #
<br />PLUMBER I COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT
<br />Address I License #
<br />MECHANICAL I COMPANY
<br />SIGNATURE REGISTERED YI N FEE CURRENT
<br />Address I License #
<br />OTHER I I?- oo~" ~y I COMPANY
<br />SIGNATURE REGISTERED
<br />Address 13.1 0 I 0 f'12 {:" '<. S /J71./ i/!n VI P ( 3 "3 ~\)h I
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />
<br />RESIDENTIAL
<br />
<br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns
<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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />1111.II,IIII.II,llll,II.',II,'IIII.IIII.II,I.I.II,II.1.,1..1.11111.11.1.11.1..1..11.11.,11,11.11..1,1.11.11.11111111.,IIII.lllllllllllllllllll,lli
<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 NC Driveways Fences (Plot/Survey/Footage)
<br />
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