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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Owner.s Name
<br />
<br />Owner's Address I 5 CO 5 4
<br />Fee Simple Titleholder Namel
<br />
<br />\- \'6~D,
<br />LUC\LE E.
<br />
<br />ARNOLD
<br />5 !:!i ST.
<br />
<br />
<br />Date Received
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />o
<br />91-\ \ ~fr L~
<br />
<br />PARCEL ID#I
<br />
<br />I
<br />I
<br />
<br />!
<br />I LOT# I I
<br />\ \ - '2(0 - '2.1- DOlO - 02800 - 01701
<br />
<br />(OST AINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />5(054
<br />
<br />sIt'
<br />
<br />~T.
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />E1
<br />D
<br />D
<br />I REPLACE
<br />
<br />X 4-- 3 I sa FOOTAGE I 10'3 '2
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />ROO~
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />81
<br />
<br />BUILDING SIZE
<br />
<br />I '2 LJ-
<br />
<br />HEIGHT
<br />
<br />1$ '225D
<br />
<br />D ELECTRICAL 1$
<br />
<br />D PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO
<br />
<br />11111 I1111 11111 11111 11111 11111 11111 11111 III I! 1111111111111111I11111111111111111I1111I11111111111111IIIIIII~ 1.111111111111111111111111111111111111111
<br />
<br />:~~~~~RE J~ tJ~ I ~~:::~ I ~~N~ 9.:cV1::f:fYIN I
<br />
<br />
<br />Address License # I I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />ELECTRICIAN
<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 />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 />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y / 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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />I11I11111111111I1111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 w/ 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 w/ 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~i:i~~~':' , , , , , , I , , I , , I , . I , , , , , . , , , . , , , , . , , . , , . , , , , , . , , , , , , . . . , , , . I . . . I I . I , I I , I I I I I I I I I I . I I I I I , I I I I I . I . , , I , I , I . , . I . , , I I , . . I I I I I , I I . I I , . . , , , , . . , ,
<br />
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (A1C 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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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