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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />reV"-O 1,)-/9.WUUL \
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<br />Date Received
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<br />
<br />')V I ZOt\
<br />G'feU\'S \()?(? ~ Dr-; ",(7,
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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 . /-j-R
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<br />Ave- 9f\~~r LO" 133'25 I
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<br />PARCElID#1 '321, 2-5 - '2) - OI~O - 00000 '-33~O I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />o SIGN D MOVE 0
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<br />o
<br />o
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<br />Owner's Name
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<br />Owner's Address 17 {() y C;
<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />1~1153 NeLA ~Ot'Y1
<br />I GyrO r)d~ () ( , Let) \
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<br />I
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<br />D NEW CONSTR E3 ADD/ALT
<br />1XI INSTALL REPAIR
<br />PROPOSED USE 0 SFR D COMM
<br />TYPE OF CO~STRUCTION 0 BLOCK D FRAME
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<br />DESCRIPTION OF WORK I mOb)' \ E:.- h a VY'eJI t1 ') t cd \
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<br />BUilDING SIZE 11- 1 K c; tLJ ISQ FOOTAGE I J 5/2- I HEIGHT I . I
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<br />11.1.1111 III""" II" 11.1:. III ~-:.. ~,.. I..' I" II"" II' 11111" I. I" II..... III' II.,.. I.... 1.11...... 11'1" I.... 1.11..... 11111'" II' 11111..... I I."
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<br />D BUILDING 1$ 351 OW, 0 () VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ 6 DO . c) 0 AMP SERVICE D PROGRESS ENERGY
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<br />D PLUMBING 1$ 250.00
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<br />D MECHANICAL 1$ J) ODD . ~ cl
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<br />D GAS 0 ROOFING
<br />FINISHED FLOOR ELEVATIONS I
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<br />SUBDlVISIO~
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<br />WORK PROPOSED
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<br />DEMOLISH
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<br />OTHER I Yil ObI \ e... '')OWl e.
<br />STEEL D OTHER I
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />t I , , t , , , I I I I I , I , , , ~ . I . t , I , . I I , I I I I , I , t . t , I , I I I I I I I , I , , , , , I I , , . I I I I , , . I , I , , , I I I I t I . . I I , . I , . . I I I , , , I I . , , . . I I I I , . . , , , . , I I , . . , , , . . I I , , . I I I , , . , . I I , f I I I
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<br />D
<br />I
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<br />SPECIALTY 0
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<br />FLOOD ZONE AREA
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<br />OTHER
<br />DYES
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<br />DNO
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<br />COMPANY
<br />REGISTERED
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<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y I N FEE CURRENT
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<br />YIN
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<br />IIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111111111111111111111111111111111111111' 11111' 1I11111111111111111111111111111111
<br />RESIDENTIAL 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 onsile, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
<br />COMMERCIAL 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 onslle, Construction Plans, Stormwater Plans wI Slit Fence Installed,
<br />. Sanitary Facllitles & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />SIGti PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for ail NEW construction.
<br />III , ! 111111I1 , 1111 , 1111'11111111 ! 111111 , 111111111111111111111111111 , 1111 , 11111111111111111111111111111111111111111111111111 i 1111111111111 j II111 j II
<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)
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<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 HIE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plol/Survey/Footage)
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<br />License #
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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