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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 Address 3 Cj03 L
<br />Fee Simple Titleholder NamJ
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<br />
<br />
<br />Owner phone Number
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<br />
<br />~~urJ 13s-72'"honONum.., I
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<br />Owner Phone Number I
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<br />Date Received
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<br />Owner's Name
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<br />,3 U /J-v&
<br />S ,4-1Yt.V
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<br />Fee Simple Titleholder Address I
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<br />3 90 3 /
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<br />JOB ADDRESS
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<br />S,(f-ltl.~
<br />~ U IJ-y~
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<br />I
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<br />D NEWCONSTR r==J ADD/ALT D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR 0 COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D
<br />
<br />DESCRIPTION OF WORK I r,. '" hK.L. 2-l{(p 'cf~1 f/1 WOe) () Fc.A/e L
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<br />BUILDING SIZE I I SQFOOTAGE I ~ lo I I HEIGHT I ~ / I
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<br />"."..",...,..",.."".....",.,.......,;,.."."..,...,...........,..."..,......,...,..,....,....,.,....,.....,........"....,...,...,..,.,..
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<br />D BUILDING 1$ 3\ 69 ."0 I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING 0
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<br />FINISHED FLOOR ELEVATIONS I I
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<br />"6 A tH--C; J:L 3 55-Y~ LOTti
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<br />PARCELID#I/Z- 2C, - 2/- 0000 ~ 07 ':J-U>--c/ObD
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />DEMOLIsH
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<br />f-eNe.~
<br />OTHER I
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<br />I
<br />I
<br />I
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
<br />DYES
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<br />DNO
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<br />,...11..111111.111111..111111.1.1.1.1111...1111111111111.........11..111.'1......11...............11....111..,1111111111111111.1111111..1111111111
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />I
<br />I Y/ N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address 1
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<br />OTHER
<br />SIGNATURE
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<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Us I}
<br />Y/ N I
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<br />License # I
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<br />Sl-u ( h,v~[../
<br />I Y/N
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<br />~4 I
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<br />Address I /1 Po I [/~ iff So. &Jaso,vkAj H 3' ~b-J<A
<br />11'1 , ~ t , II , I , t I , I , III , I IIIIII , I I11III I , 1II11IIIII t . I 111I , I II till' , I11I111 , I111II1111111 t 111111111111111111111 t I , II t , II , t II , 1111111 " 1II1II111I , II I
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<br />FEE CURRENT
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<br />License #
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<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 onslte, 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
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<br />SIGN PERMIT
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<br />. I I I II I I I II I I I III I I I I I I I I II I II I I I . I II I I I II I IIII I I . I & II I 'II ~ I II I I i & I & I I IIII I I ~ I I III I I I i I II I i II I I I I i II i I I II i I i I I I II i I i II II III Iii II I i I . i i Iii i i Iii i II i i
<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 (Plot/Survey/Footage)
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