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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-1/jU-UU~1
<br />
<br />Date Received
<br />
<br />
<br />5 \\-oeo
<br />D~ '\E.
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder NamJ
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />5~-1 Olp
<br />
<br />LOT #
<br />
<br />\b
<br />
<br />SUBDIVISION
<br />
<br />\' A '(2. \L '\) Q.
<br />CD \) 10 '\ (l..\.) DAK:S . Sv"l
<br />,
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCELlD#1 ~-O\s-~ \- C:lO\O - \\500-- 0\00
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE 0
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />o
<br />o
<br />
<br />B'
<br />o
<br />o
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLIsH
<br />
<br />o
<br />o
<br />o
<br />DESCRIPTION OF WORK I \ N S --f A \... L- D '; E ? . ~ ~ {2, ~ 'f'V\ () Q -r; L-
<br />BUILDING SIZE I {?- Y 's s I SQFOOTAGE ~ 'J.. 0 I HEIGHT I . I. .
<br />
<br />, . , , . , , . , , . , , , , , . . , . . , . . . , . . , , . . . , . . . . . . . . . : . . , . . . . . I I . ~ . . . . II . I I . I . . : . . I I . . . . . . . I I I I . I . I I . . I I I I . , I I . I I . . . . I . . . I I , . . . . , I . I . . . , . . . , I I . , . , , , . , , . . . . ,
<br />
<br />D BUILDING I$.~ j ~b. \'~6D .~
<br />,
<br />D ELECTRICAL 1$ I' AMP SERVICE
<br />
<br />D PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />o GAS 0 ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I \" A (Z. ~
<br />
<br />I
<br />\M [) 0'6 L I .
<br />
<br />I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />Address
<br />
<br />ELECTRICIAN I.
<br />SIGNATURE
<br />
<br />
<br />\P'
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />\'\At)~) LE, H ow ~
<br />FEE CURRENT Y I N
<br />
<br />License # It \-\ 0 00 0 l 0 \ .
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />C\T
<br />
<br />
<br />~L. \.>(" - '\ ~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT Y I N
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />o.J2LG
<br />
<br />b
<br />
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />V\o1 \) /3.1 Li? \-to ~~ er
<br />FEE CURRENT
<br />
<br />License # I \ ~ . 0 O"b \::, \ 0 \ I
<br />
<br />I
<br />Y/N
<br />
<br />I
<br />I
<br />Y/N
<br />
<br />I
<br />
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />1111111' III , ' t I , , 11111 I 1111111 . 1111111111111111111111111 , 1111111111111111111111111111 , I , 1111111111111111111111111111111111111111111111111111111III
<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 onsile, Construction Plans, Sanitary Facilities & 1 dumpster
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) liet of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onsile, 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 all NEW construction. .
<br />~ I1I11I1III1 ~ 11111111111111111111111.1111111111.. ~ 11111'. 4111 ~ II i 411114 1 ~ I111I1 i 11111 i III i i i 111.1 i II i .111 i I i II ~ II i I ill.. i III i i III i II i i I'i i i III 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 Commencement Is required, (AlC upgrades over $5000)
<br />
<br />Agent (for the contractor) orPower of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Fronl of Application Only)
<br />Reroofs Sewers Sel"Vice Upgrades AlC Driveways Fences (PloUSul"Vey/Footage)
<br />
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