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<br />81;1-780.0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />
<br />Fax-813-780-0021
<br />
<br />S1
<br />
<br />Date Received
<br />
<br />2 -1~()
<br />GARR. 'I !< l/lJv
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />I 3 C;>SUO JRI) AIJF-_....,
<br />Owner's Address 0 I '1..
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />38 g 'It> 3/lP nu(.
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />~
<br />
<br />LOT #
<br />
<br />PARCELID#ln -1.(.,.-2./-0(;)10 -/~70l> -DOI/
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />SIGN
<br />
<br />o
<br />
<br />MOVE
<br />
<br />D
<br />
<br />DEMOLISH
<br />
<br />eg
<br />
<br />PROPOSED USE D
<br />
<br />TYPE OF CONSTRUCTION D
<br />
<br />151..J'~P /0/"'1' v /,..;/,..,1/
<br />DESCRIPTION OF WORK n;: () l' '" r
<br />
<br />BUILDING SIZE 110 I ~ II '1 J~I If 1/ . I SQ FOOTAGE I I G 'I HEIGHT I / / I 'I 1/
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<br />
<br />~ BUILDING 1$ /2.00.00 I II~~LUATION OF TOTAL CONSTRUCTION
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER 15HED
<br />STEEL 0 OTHER I
<br />
<br />D
<br />D
<br />D
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~O
<br />
<br />1111111II1111I1111111II11111II111I1111I111111I111111111I11II111II1111I111111111111111111111111111111111111III11111111111I11I1I11111111111111111I11
<br />
<br />Cjb. ~I
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />cJjaAAy
<br />
<br />7(~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Ow/V/3A-
<br />I Y I N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />388,/0 3fJ.,J
<br />
<br />f)uE
<br />
<br />~ III L.L5
<br />
<br />33~4t...
<br />
<br />Address
<br />
<br /> LIcense #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address License #
<br />I111111I11111I11111I111I1111111111111111I11111111111111111111111111I111111111111111111111111111111I11111111I111111111111111I1111111111111111111111
<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 subdivisions/large 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 on site, 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 />SIGN PERMIT
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<br />DI~~~ti~~~': ' , , . , . , , , , . , . , , , , , , , , , , , , . , . , , . , , , . , . , . . , . , . , , , , . . , , , , , . , , . , . , , , . , , , . . , , , . . , . , . , , . , . , , , , , . , , , , , , . . , . , , , , , . . , , , . . , , , , . , , . . . , . . , , . , , . , , , ,
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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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