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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-81 :i-I tlu-uu;n
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<br />Owner's Name
<br />
<br />\.-\0.-
<br />Owner's Address I &5 (7-0'3
<br />Fee Simple Titleholder NamJ
<br />
<br />
<br />
<br />Date Rec~lved
<br />
<br />\ ,-\"h
<br />
<br />Sk:
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<br />Fee Simple Titleholder Address I
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<br />5203
<br />
<br />/7/L.
<br />
<br />sf
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<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />, PARCEL ID# I
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />El'
<br />o
<br />o
<br />
<br />IXI
<br />
<br />E3
<br />
<br />PROPOSED USE D
<br />
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I 6 f7C. VI (: ~ IC[:)? h I ~
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<br />BUILDING SIZE I I SQFOOTAGE I. ' I HEIGHT I ,I
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<br />, , , , .. , , . , , , , , . , , , , . , , , , , . , , , . , , , , . , , .. , .. , : , .. .. .. , .. , .. , .. .. , .. .. . .. , .. . .. .. .. .. , .. .. . , .. .. . .. . .. , . .. , , .. , , , .. , . .. , .. , .. , , .. .. . .. , .. .. .. , , .. .. ..
<br />
<br />ADD/ALT
<br />@!B>
<br />COMM
<br />FRAME
<br />
<br />\ \ - a~ - ~\ _ 60\0- \ q(oOb- co70
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLIsH
<br />
<br />SUBDIVISION
<br />
<br />D
<br />D
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />I
<br />I'
<br />I
<br />
<br />OTHER I
<br />
<br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
<br />~ ELECTRICAL 1$ I AMP SERVICE (p <-> t=J RGY D W.R.E.C.
<br />15"0
<br />D PLUMBING 1$ 1
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS 1 I FLOOD ZONE AREA DYES DNO
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<br />, . 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 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 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 I I I I I I I I I I . I I I I I I I
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<br />I
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I, /J12L /J /C
<br />SIGNATURE ,~
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />License #
<br />
<br />E-t1~/C'
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />J-
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I ntJDct!o vise
<br />I (JJ/ N I
<br />n5S
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N FEE CURRENT
<br /> License #
<br />Y / 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 />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />1111 f 11111111111111111'1111111 '11111111111111111111111 I II I I I 1111 I 111111111" I I 1111 I 11111111111111111" 11111111111111111111111111111111111111111111
<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 onslte, Construcllon Plans, Sanllary Facilities & 1 dumpster
<br />COMMERCIAL Attach (3) sels of Building Plans; (1) !?et of Energy Forms.
<br />Minimum ten (10) working days after submittal dale, ReqUired onslle, Construction Plans, Sanitary Facllilles & 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, .
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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. (Ale upgrades over $5000)
<br />
<br />Agent (for the contraclor) or Power of Attorney (for the owner) would be someone wilh notarized letter from owner author/zing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Driveways Fences (PloUSurvey/Foolage)
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