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<br />81~-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />t-aX-tll;:l-(tlU-UULI
<br />
<br />Owner's Name 0 ~ V "
<br />
<br />Owner's Address I '3 OJ 0
<br />Fee Simple Titleholder NamJ
<br />
<br />
<br />
<br />Date Received
<br />
<br />PA c<-Ic Dr
<br />
<br />Fee Simple Titleholder Address
<br />
<br />I
<br />I
<br />
<br />l
<br />3~oLjI
<br />
<br />P A t1- Ie
<br />
<br />Ov I
<br />
<br />PARCEL ID#I /2.- 2..& -2/ - 0030,- DO/GO -OCX-O
<br />, (OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN D MOVE D
<br />
<br />o
<br />D
<br />
<br />LOT i#
<br />
<br />JOB ADDRESS
<br />
<br />I
<br />
<br />B'
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<br />D
<br />DESCRIPllONOFWORK I ttevou I- . 2,'-1 <;~ 1_/ ~~YCQV Tt'Mbwi,it.(
<br />BUILDING SIZE I !I sa FOOTAGE I 2-l..{ Q U I HEIGHT - ,I
<br />
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<br />
<br />D BUILDING 1$ L/CJyOrU u I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE t=J PROGRESS ENERGY
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS ,OJ ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />o
<br />D
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLIsH
<br />
<br />WORK PROPOSED
<br />
<br />I
<br />I'
<br />I
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<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0
<br />
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
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<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y IN FEE CURRENT
<br /> License #
<br />YI 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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />H
<br />REGISTERED FEE CURRENT Y I N
<br />Address I J~ 0 I 0 ~~. s: L f/cJ lJok /I~' 'I License # Ieee 0 S-7 q \7 I
<br />
<br />III1 ' I , , II II . , II 1 ~ I I I ' I II I ; I":': 11II , I ~ II ~ I ;-;-; II ; 1,11111 , III , IIIIIII~ II, II I , , 1I111 , , II , II , 1111 , 1I1I11 I1111111I11111 III , ' I1I1I1111 · , 11I1111111111 I' I
<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 />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. ,
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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. (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 AlC
<br />
<br />I~
<br />
<br />COMPANY
<br />
<br />
<br />Address
<br />
<br />----
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways
<br />
<br />Fences (PloUSurvey/Footage)
<br />
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