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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 />Owner's Name
<br />
<br />
<br />'I It) lof.p
<br />
<br />l.V .e , &.. '... ,-
<br />~~7.7- 17
<br />
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I T I) - ~ I S- - ~" c 0
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder NamJ
<br />
<br />SI
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />;)57-7-
<br />
<br />17 j"
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<br />LOT #
<br />
<br />I
<br />
<br />D NEW CONSTR D ADD/ALT ~
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR 0 COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I 1 Ai L t4 12. G; 6" -z.... 1) li=c }L 5
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I
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<br />.. , , , , , , , , , , , , , , , . .. . , , .. , , . , , , , , .. , , , .. .. , : , , .. , , , .. .. , , , .. , , .. .. , , , .. , , , , .. .. , , , , , . . , , , , .. , , , .. .. . , .. , , , , , , , , , .. . .. , , , , , . .. . .. , .. , .. , .. .. .. .. , ..
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<br />D BUILDING :$ & t?O . e><Z> ~ ~:
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<br />D ELECTRICAL $ ."'7-11 ") ~ . . AMP SERVICE D PROGRESS ENERGY D
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<br />D PLUMBING 1$ I bp:.""'~\L,;;O )~Iot,
<br />{}~~i ~ >'Jj~Ir4.{;
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION ;;;i~ L):tv..:f?~ '5J2.i:->
<br />
<br />D GAS D ROOFING 0 SPECIALTY D OTHER ~V ~))f}N)
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />
<br />..1111.1111..1111...111..111..11...111......11........111....11..1111....11'.........11..................................11......11...............
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<br />
<br />Co, j ';-f ~~~~:R~~
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<br />PARCEL ID#I
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<br />SUBDIVISION
<br />
<br />/1 -d.b-21- 0010 - /4/00 - ()/7o
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />OTHER I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />W.R.E.C,
<br />
<br />BUILDER !
<br />SIGNATURE
<br />
<br />Address
<br />
<br />~r~~
<br />
<br />r .
<br />
<br />
<br />
<br /> License #
<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 />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />11111111111111' 1111111'11111111111"11111111111111"""""""111"'1111""1'11""1""11'11""'111111""1"""'11"11'1"""'111111111"
<br />
<br />RESIDENTIAL 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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
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<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 Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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