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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
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<br />
<br />
<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />I 3q35 UlARkty R,'d<j ~
<br />I rvlClje.s-f(v OcJC) I PARCELlD#1
<br />r:=J. NEW CONSTR c=J
<br />[Z] INSTALL D
<br />PROPOSED USE 0 SFR D
<br />TYPE OF CONSTRUCTION 0 BLOCK D
<br />DESCRIPTION OF WORK l-po.r k- \YL0clJ. sed-~p
<br />I /3)( 3'2 ! I SQ FOOTAGE I L{ 91
<br />
<br />111111111111111111111111111111111111111111111..,1...11..111.................11......111111,..111...1111111111I11IIIII1I1I1111111111111111111111111
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<br />D BUILDING 1$ )6 r::> 0 0 .0 lo. I
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<br />,
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<br />D ELECTRICAL 1$ Lf50. () b I
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<br />D PLUMBING 1$ 200.06 I
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<br />D MECHANICAL 1$ 500. (50 I
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<br />D GAS 0 ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />
<br />I . , I I I I I , I II ~ , I , . I I . I I I , I I I I I II I I t I I , I I I II , I I I , , . I , . I , , , I , . . I , . : , . I I . I I I , . I II . I , . . , , . . , I . I I I I I I I I I fI II , I II' . I , I I , I , , . I , I I , I I , I I I , I I , , I ., I " I I , I I II
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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
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<br />I
<br />I
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<br />I LOT> I 7'3 :
<br />1~~2(O'- tl- 0060-(X))C:D-OOU
<br />(OBTAINED FROM PROPERTY TAX NOTICE) '0
<br />o SIGN D MOVE 0 DEMOLISH
<br />
<br />D
<br />o
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />OTHER I pa..v It-W'l 0 cl.t.-J
<br />STEEL D OTHER I
<br />
<br />BUILDING SIZE
<br />
<br />HEIGHT I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
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<br />AMP SERVICE
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<br />o
<br />
<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 />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />I ~kt!fM.l:JJ1J
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<br />
<br />License # I
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<br />Y/N
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<br />I CVOJldeJ/
<br />I Y / N I FEE CURRENT
<br />License # I
<br />I ~~ ;f1~'~ fuRRt:1 tu;
<br />
<br />
<br />License # I
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Ll?cch YJ.
<br />Y I N I
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />,I Y I N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
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<br />11111111111111111111111111111111111111111 till 11111 11111 11111 11111 111111'11 11111 11111 11111 11111 III I 1111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Farms; R-O-W Permit far new constructian,
<br />Minimum ten (10) working days after submittal date. Required ansite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisians/large 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 submiltal date. Required ansite, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new prajects. All commercial requirements must meet campliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans. '
<br />*"'PROPERTY SURVEY required for all NEW constructian.
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111 " 1111111111111111111111
<br />Directions:
<br />Fill aut application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Natice of Commencement is required. (AlC upgrades aver $5000) .
<br />
<br />Agent (for the contractar) or Pawer of Attorney (for the .owner) wauld be sameane with natarized letter from .owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front .of Applicatian Only)
<br />Reroafs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if an public roadways..needs ROW
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