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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 Recfilived .
<br />"'H1Tt'
<br />
<br />Owner's Name
<br />
<br />
<br />l?v~dcl (lOI1c!O Ass- QC
<br />(OM;, (.Jar! ,//
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number 1
<br />
<br />Owner Phone Number 1
<br />
<br />Owner's Address I 3l? 3.3 '3
<br />Fee Simple Titleholder Nam~
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />! 3f ZYs- 130)(tvooo/ /Jv
<br />I I
<br />
<br />B
<br />
<br />PROPOSED USE 0
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK ~roDf E6 S 0 Cer~l'lI'\.~e
<br />
<br />BUILDING SIZE I I SQ FOOTAGE J ffboo HEIGHT I! 1
<br />
<br />..."'...'.'..........'..."........;'....:..'.....'...,.............,.....,.,..,.,..........".... .......,....,..........,..,...........'..'..1
<br />
<br />o BUILDING 1$ /C: ~c.J 1 VALUATION OF TOTAL CONSTRUCTION
<br />o ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
<br />o PLUMBING 1$ I
<br />o MECHANICAL r- I VALUATION OF MECHANICAL INSTALLATION
<br />
<br />o GAS ~OOFING 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCEL ID#/U 2. - "Llo- 21 -Ol,Ji4 -lJor1oo
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />- 00(,0
<br />
<br />B
<br />o
<br />o
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />
<br />
<br />D
<br />
<br />WR.E.C,
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />..,',.....,....",....,....,..",....,.....,..,....,....,',..,',..,.,.....,.,....."...........",........".,',.,......,",....,.....,..'.""111
<br />
<br />I
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />YI 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 />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />~,~~~"ruRE I t2<v p0 ~ ~"
<br />Address ~ ~ ,~.~.. ~~ .( 2 ff /t7V I':h n. I-!
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I
<br />
<br />}- COMPANY
<br />; R'G""""D
<br />
<br />30"7"- I
<br />
<br />Y/N
<br />
<br />
<br />License #
<br />
<br />~~C c oJ7f.r7
<br />
<br />RESIDENTIAL
<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 onslte, 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"..1.1,1111,1.1,1.1.1111.1.1.1,1.11.11,1.11,1.1.1,1.,.1"..,,1.1.1.1.,111.1111.1.1.111111.111,1.11111I,lllll.I,..I.I,III,IIIIIIIIIIII.III;
<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)
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