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<br />813~780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received 5-)
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<br />Owner's Name Gyq C ~-Z '')VJ
<br />Owner's Address 17 u if S &e~r) ~ lotx'../ (Jy') / €-,/
<br />Fee Simple Titleholder NamJ
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<br />Fee Simple Titleholder Address I
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<br />13-7 hL/2. Cd! A ve-
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<br />I GVOrid HOYt26h I
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<br />D" NEW CONSTR c=J
<br />CLr INSTALL D
<br />PROPOSED USE D SFR 0
<br />TYPE OF CONSTRUCTION D BLOCK 0
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<br />DESCRIPTION OF WORK I m O\] i \e \" () \tY) e, ~ e -+ -\..l ~
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<br />BUILDING SIZE I '2> " x. 5 -, I sa FOOTAGE I 17 Co 7
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<br />,....,11,..,.,1111111,.,...........,11..,........".......,.............,..,11111111111."....11111111.1,...'.1111111111111111111,...1111111111111
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<br />D BUILDING 1$ 35000,c> ~
<br />D ELECTRICAL 1$ j f::f::D ,C> 0
<br />D PLUMBING 1$ 2;0, cO
<br />D MECHANICAL 1$ IWQ, ()C>
<br />DGAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />I LOT # 12&1'
<br />PARCELID#13Lj-2-S~ 2J -Or76 -OQOCO-2&/16
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />D
<br />G
<br />D
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<br />DEMOLISH
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />OTHER
<br />STEEL
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<br />I mOD l-'-e hoY1-\ <---
<br />D OTHERI
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<br />I
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<br />HEIGHT I
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<br />ROOFING
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONEAREA
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<br />OTHER
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<br />DYES
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<br />C~Z:rNO
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<br />BUILDER
<br />SIGNATURE
<br />Address (). -f -{ ~ ~, it
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<br />::C;;;:~~;N!. ~~/
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<br />Address ,
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<br /> I Bf-t,fd,f)eJd /Vl (-Is Y/N
<br /> Y I N I FEE CURRENT I
<br /> License # I
<br />COMPANY l!fre
<br />REGISTERED Y I N FEE CURRENT Y/N
<br /> License # I
<br /> I Er/e-/e{1dd IV! (~j Y/N
<br /> Y I N FEE CURRENT
<br /> License # I
<br />COMPANY I~c~
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y I N FEE CURRENT Y/N
<br /> License #
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<br />PLUMBER
<br />SIGNATURE ~A-
<br />Address .. gc 86 -I-:/p./, of 1- /)
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<br />OTHER I
<br />SIGNATURE
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<br />Address I
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<br />RESIDENTIAL
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<br />I . , , , , 1 t I I 1 , I I I I I , I I I I r I I I I I I I I 1 1 , I I I 1 , r I I . I 1 I I . 1 , fl I I , 1 , , I I I I , , , I I I I , ~ 1 r I 1 . , , , , I 1 , 1 , , , , I I , I I I I , r I I I I , , I I . 'ff , I I I 1 I 1 1 . 1 I I I I II , I I I I I 1 I I I 1 I I I I I I I I I I
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<br />COMMERCIAL
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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 onsite, 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 onsite, Construction Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requiremenls must meet compliance.
<br />Attach (2) sets of Engineered Plans,
<br />....PROPERTY SURVEY required for all NEW construction,
<br />
<br />SIGN PERMIT
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<br />II ~ , IIII1I , ~ , I ~ I ~ III . I I ~ II. I 1III1II ~ . . 111I ~ . II . . ~ I j ~ . I..~ I . I . I I. I ~ ~ . . 11II . 1111. I1I1IIII ~ ~ j i II J ~ I 11111. ~ . III i j I , III j ~ ~ 11III ~ J I1IIII , II i 11111111111 i i
<br />Directions:
<br />Fill out application completely.
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<br />Owner & Contractor sign back of application, notarized
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<br />If over $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
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<br />Agent (for the conlractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner aulhorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />
<br />Reroofs Sewers Service Upgrades NC Driveways Fences (PloUSurvey/Footage)
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