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<br />81:1-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />
<br />OWner Phone Numb
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />
<br />
<br />(- '2
<br />
<br />V Owner's Name L :Jrr 8 I ddl-n
<br />,/ Owner's Address 13?f), '11 uIt;'/5-;:'~~i" #ve
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />3Y5<t1 W{~/ f-/.,tdeh II V e
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />o
<br />o
<br />
<br />S-/eet1 y ;tlJ,:tV!11eb,( Jll9hte lisf 2qJhr. ;1Ie- LOT# /<7
<br />
<br />PARCELID#I 02/ 2-(;,- 2-l-D'2-~ -00000... al <=to
<br />(OBTAINED FROM PROPERTY TAX NOTICEI
<br />SIGN 0 MOVE 0
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />,/ JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />o
<br />o
<br />f(e 111 W~ CI Ii
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />V DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE I /1- X II ''t " I sa FOOTAGE I /0/ tl I HEIGHT I 8' ' I
<br />111111"1'1111'11111111111111111'111'1111'11"11'111111111'1111'1111111'11111111111111;11111111111'11111"11'111111111111111'11111111111111111111'
<br />
<br />steel wall
<br />
<br />f(e (-zee
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />~~.ft,. 11 fa"!
<br />
<br />OTHER I
<br />
<br />Jw,d
<br />
<br />?11 iJ leJ','3(
<br />
<br />D BUILDING ,/ 1$ I
<br />. / ;JJ)O .
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING 0 SPECIALTY 0 OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111111111111111I111111111111111111111111111 ~ 111111111111111111111111,111111111111111111111111111111111IIIIIIIIIIIIIIIIII~ IIIII.'C 11111111111I111111
<br />
<br />BUILDER \'f-' /). COMPANY \-\~~"YU- 0 L .....
<br />SIGNATURE {j....;. /./ J. I "Y'_ ~/'?':'~f'.Y / REGISTERED I Y I N I FEE CURRENT I Y I N
<br />
<br />Address \1 License # I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<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 />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I 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 License #
<br />1II111111I11111111111111111111I111111111111111111111111I11111111111I1111111111111111111I11111111111111111I1111111111111111111111111111111111111111
<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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge 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 dale. 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 , , , , , , , . , , , , , , , , , , , , , , , , , . , , , , . , , , , ,
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<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
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