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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 />Owner"s Name
<br />
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<br />Owner.sAddress (P6!!' J !(tc4rw4'f d/(
<br />Fee Simple Titleholder Namel
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<br />1Jf.:hir
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Date Received
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<br />X~~10~ ~~
<br />2ej()hT/2~;(/~F I PARCELlD#lo-o-9<.o-d.-t 01300000D
<br />, (OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />E1 NEW CONSTR D ADD/AL T D SIGN D MOVE ~
<br />INSTALL D REPAIR
<br />
<br />PROPOSED USE D SFR D COMM D
<br />
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I ,(Fk,orIE r--/Fcl/LIC SE"RVtCC
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<br />I sa FOOTAGE I
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<br />JOB ADDRESS
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<br />loO~ ,
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<br />LOT #
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<br />C> 51 D
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<br />Fee Simple Titleholder Address
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<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />OTHER 1
<br />STEEL D
<br />
<br />OTHER 1
<br />
<br />BUILDING SIZE
<br />
<br />HEIGHT I
<br />
<br />TIIIIII'-IIIIIIIIIIII"IIII"IIII,IIIIIIIII".IIIIIII,111111111111111111111"1111111'11'1'1'111111'11111111111111111111111"1111111111111111111111
<br />
<br />1$ I
<br />1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
<br />
<br />I1I11II1111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111II111111I11II111I111111111111111111111111111
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />/700t1!:-
<br />
<br />D
<br />wi
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />/5DA
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<br />D
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<br />PROGRESS ENERGY
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<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
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<br />YI N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />, Ir@ N -I r FEE CURRENT I(') I N
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<br />License # I
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<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />z--#~ /1;
<br />
<br />I
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />I1111I111111111111111111111111111111111111111111111111111111/111111111111111111111111111111111111111111111111111111111I1111111111I
<br />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 onsile, 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.
<br />
<br />Di~~~ti~~~': . . . . , , , . . . . . . . , . . . . , , , . , . . . , , , , . , . . . . . , , . . . . . . . , . . , , , . . , , , . . . . . , , , . . . . . , . , . . , . . . , . , , . . . . . . . . . . . . . . . . . . . . . , . . . , . . , , , . , . . , . . , , . , . , , , , . , . .
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<br />Fill out application cpropletely.
<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 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 AlC Fences (PloUSurvey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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