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<br />81 :3-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received , 1- '2. g. - 6G::,
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<br />Owner's Name P hi' I i (! . rYlax-+....
<br />Owner's Address I '3 1 tn.;Jd Nw.J-loy I "2 D Y1 s 13\ V d. .
<br />Fee Simple Titleholder Namel
<br />
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<br />Fax-813-78~,t#1
<br />Ten() ,"e..
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<br />Owner Phone Number <?J 3. 78<6- 757'-1
<br />Owner Phone Number I
<br />Owner Phone Number I
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
<br />13,1.,,;);;/ New t1t>("\ 'ZDV15 B)",d.
<br />
<br />I GrOYld -Hori zaYlS
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<br />LOT #
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<br />BUILDING SIZE
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<br />I
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<br />,......11....11............'.....11..11.11.."'"1.11....'"11..11........11111........11...11............,...11'.11.111....'"1......11...1111111111
<br />
<br />I
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<br />D NEW CONSTR D ADD/ALl J2CI
<br />D INSTALL D REPAIR
<br />D SFR D COMM D OTHER
<br />D BLOCK ~ FRAME D STEEL D
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<br />I ~-\- 0+ +we've- ~5SI2e- -Fr>Y-Size
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<br />I SQ FOOTAGE I I HEIGHT I
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<br />PARCEL ID#I
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<br />SUBDIVISION
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<br />34. :lS-~' , 0 oct 0 - (jOf)OO -O~J-O
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />PROPOSED! USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER I
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<br />DESCRIPTION OF WORK
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<br />~ BUILDING 1$ 5/~q<6'aV I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C.
<br /> ~,(/
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION Q(.f('l\-v- - /Se n. \- \ G.. Ie
<br /> ~ 0\ Au--\"ho (I 2-
<br />D GAS D ROOFING D SPECIALTY D OTHER $ 20 .C:YD
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />I I I . I I I I I I II I I I , . . I . . I I I , , , , , , I . . I I I . I I I I I I I I I P , , . . , , I , , , , I I I I I . I III I I I III11 I I I , I , , I I ~ I I . I I . II , , , , , , II , II I I , . I . I , I . , . . . . I I , , , , , I I , I I , II , , , , I I , r . I .
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<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
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<br />I
<br />I
<br />I
<br />I
<br />I
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<br />I
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<br />CjD +.~
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<br />BUILDER
<br />SIGNATURE:
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE:
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE:
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE:
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />License # I
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<br />A~ ~A M JJ.I ~ A A 1_ COMPANY I3ozar.J-h Ins-kLLUch'rrn5>
<br />SIGNATURE: ~VY~'O~aa/t::i17-. REGISTERED I YI N I FEE CURRENT I Y/N I
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<br />IIIII~I~~::~:IIII~~ I ~~~ ~~'II~ l~t;I~~~~~ I ~~I~~~III! 1111111111111111111 ~:~~~::I~IIIIIII~~I~~~~~ 1I1111 "
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<br />RESIDENTIJ~L Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. 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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC
<br />
<br />Address
<br />
<br />OTHER
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (PloUSurvey/Footage)
<br />
<br />Drivew~lys-Not over Counter if on public roadways..needs ROW
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