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<br />81a-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Date Received
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<br />
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<br />Owner's Name C _ L. t.. s. R ~ €.c E-
<br />Owner's Address I S-, 5';L / ~ 1!J. s r
<br />Fee Simple Titleholder Namel
<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 />
<br />ISS5:L
<br />I
<br />
<br />/r-B
<br />
<br />5/
<br />
<br />B
<br />
<br />PROPOSED USE 0
<br />
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK I 4\?O'J.e- <q~uN D 5\u1(\'\fl'\.INEt 7C9-0&.- flU $.pq..J.,J.,.. ~\'5"'3~)
<br />
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I
<br />TlTIT'Tf'TTnT\ III . II , 111111111 , I , ' I ' II , 111111111111111111 , 1111 ' 11111111 ' 111111111 \ II , ; , II , 1111111111 , II ' 111111 ' 1I1111 t 1111 , I ' I , 11111111111111111 t
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<br />-1360.00 I
<br />I
<br />I
<br />I
<br />D
<br />I
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<br />JOB ADDRESS
<br />
<br />I
<br />B
<br />D
<br />o
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<br />SUBDIVISION
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />o BUILDING 1$
<br />
<br />o ELECTRICAL 1$
<br />o PLUMBING 1$
<br />o MECHANICAL 1$
<br />
<br />o GAS 0
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />ROOFING
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />'l.' E ELECTRICIAN
<br />{ ~IGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />LOT #
<br />
<br />PARCEL ID#I ~ , _ 0\(0 - ~ \ _ C:J::) \ b - \ \;l, 00 L.o 6 I (00 I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
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<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />pJ Or!-./
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />License #
<br />
<br />11I11I11111111I111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<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 onsile, 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 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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<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 , , , , , , , , ,
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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. (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 THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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