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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-81 ;j-7!lU-UU~1
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder NamJ
<br />
<br />
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />LOT #
<br />
<br />-.GJ-tE12.0-.(,-FvE WAk~ f4eL
<br />
<br />I
<br />
<br />~ NEW CONSTR [=:l' ADD/ALT D
<br />tj INSTALL CJ REPAIR
<br />PROPOSED USE 0 SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D
<br />
<br />DESCRIPTION OF WORK I ~~\l AJQ.I..()?DO A.. U\AJu,-c;.)v.-1' ~Jl.~.J:C.JI
<br />
<br />BUILDING SIZE I I . SQFOOTAGE I. . I HEIGHT I . . I. .
<br />
<br />I , I . , , . , , I , , , , , . . , , , , , , , . , . , . , . . , . , , . , , . . , I : . . . . , . , , . , . ~ ' . , . .. . , . . . . . . . . , I . . , . . . . . . . I . , , . . . . I . . I . . . I . , , . . . , , . . . . , . , , . , , . . , , . , , . . , , . . . . . , , , I . . . . , I .
<br />
<br />D BUILDING 1$ 1,'100 VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ AMP SERVICE t=J PROGRESS ENERGY
<br />D PLUMBING 1$
<br />D MECHANICAL 1$
<br />
<br />D GAS 0
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />PARCEL 10#1
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLIsH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />
<br />I
<br />I'
<br />I
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />ROOFING
<br />
<br />D
<br />I
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />,.111111111.11111111..1111111111111111111111111111111........111...........11.........'.....11.11..'...111..111111..1111111111111...1111111...1111
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br /> z;:)~" .\.c.....
<br /> FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I ~ It.. l\
<br />SIGNATURE .. ,~~~I~
<br />Address I ~O ~,,?- "'"2.-~\\" F-\. ~~S'C;
<br />PLUMBER I
<br />SIGNATURE
<br />Address I
<br />MECHANICAL I
<br />SIGNATURE
<br />Address I
<br />OTHER I .1
<br />SIGNATURE .
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />1111111'11111111111111111111111111111111111111111111111111111111111111'11111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIilllllllllllll
<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 onslle, 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 onslte, Construction Plans, Sanilary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for ali NEW construction. .
<br />I I.' I I I I II I II . I I I I I I II ~ I I I I I II II I II I I I ~ . ~. . I i II I ~ I I , III1 lOr . ~ I I I I . II I I I I ~ I . I I I I I I . . I I I . i I I Iii i i II . I i J I i I I I I i I i I I I I r. i I i I I I I . I I I i j II I i I Iii ,- i i i i -'I i i Iii i
<br />Directions:
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Comm~ncement Is required. (AlC upgrades over $5000)
<br />
<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with nolarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Driveways Fences (PloUSurvey/Footage)
<br />
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