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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-B 13-780-UUL 1
<br />
<br />Date Received
<br />
<br />
<br />Lo y (1 -0 (p
<br />Ntw f'A; lleN~' ~'- l.,L L
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address ''I ~I;)?:, l0, N Q ~l<~~\c...A
<br />
<br />Fee Simple Titleholder NamJ
<br />
<br />~ \j{L...
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address
<br />
<br />LOT #
<br />
<br />JOB ADDRESS S~~t 5~ 5\. ,
<br />SUBDIVISION (. i l" J- 2f P ~'\ f l: ~~s I
<br />WORK PROPOSED 8 NEW CONSTR E3
<br /> INSTALL
<br />PROPOSED USE 0" SFR D
<br />TYPE OF CONSTRUCTION B BLOCK 0
<br />DESCRIPTION OF WORK ~~ ~ uJ 6\ ,
<br />
<br />ZeY"-\1r\-.\\s
<br />.
<br />
<br />PARCEL 10#1
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />BUILDING SIZE
<br />
<br />\'l~O
<br />
<br />
<br />~L
<br />
<br />
<br />\\ -"2 b- 2 \ -oO'()-I'L'-,OO --C:D\ C)
<br />(rTAINED FROM PROPERTY TAX NOTICE)
<br />S~GN 0 MOVE 0 DEMOLISH
<br />
<br />I
<br />61(,tP
<br />
<br />D
<br />D
<br />D
<br />
<br />I
<br />o
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />HEIGHT I
<br />
<br />~(
<br />
<br />11....11.,....".,1,..........1..,1,..,...,1,.".,1111.,...,1,.,1,.,1,.....1111........,1.....,...1.,1,.,1.."'1,,""1111111111111""'1"1"1111
<br />
<br />o BUILDING 1$
<br />S-S, -SOU
<br />.
<br />
<br />o ELECTRICAL 1$
<br />'2.,ICU
<br />o PLUMBING 1$ '?:', ~ (; ,,)
<br />O MECHANICAL 1$
<br />. .~, 1..-0":>
<br />o GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I ~( , ~~ I FLOOD ZONE AREA DYES ONO 'No {?P&lurc€. Shtud
<br />
<br />
<br />1"""""""""""""""""1"""""""""..l................,.......I...............,.........,.............,..,.....,.~~~
<br />
<br />
<br />BUILDER I -,-_.... \'\ I COMPANY I N~ (Y\~ ~ I
<br />SIGNATURE ~ f\A~ REGISTERED I C!JI N I FEE CURRENT VlI1Q:.PN I
<br />License # I C GC \S,,-l ~CI I
<br />fPi:t~ j3t.eaPI~rliI14'?t.t!r
<br />r tv N FEE CURRENT Y N
<br />License # ~3~;$~2-- I
<br />~f'E~~1 I
<br />License # I f2-F 6 (J6 d; f; 1/ I
<br />I {(jJ'ilI's ~~M~Nsr<d/~ I
<br />, License # I ~#~t75"?"yq.9 I
<br />I
<br />I
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />tJoC
<br />Row ~(n'.\-~d- l.:1iQ
<br />VALUATION OF MECHANICAL INSTALLATION
<br />PM~o ~ ~)!b &h~
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />III I III IIII I I I I I , I I I II I II I I I I I I , II I I I I I I I II I I I , II II II I II I I II J I II I , I I I I ~ I II I , , , I I , , IIIII II III I I I III , III IIIIII , , I IIIIII I I , I I I I , I I I , III I I , , IIIIII I , II
<br />
<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 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,
<br />
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />/
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />IIII .. II. ~ III1IIIIIIII11 111111111111 ~ ~ III1III1II11 . 11111&1111 III & III . IIII ~ H 111111111111111. . IIII H 1111 ~ I ~ III . I III . ~ I II I . III H IIII I 111111 1111 11111
<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 Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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