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<br />813-780-0020
<br />
<br />Date Received
<br />
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<br />':00JJ 6 A{L
<br />Owner's Address Is 5" O~ 1 ~ t\... S't
<br />Fee Simple Titleholder Namel f\J \ f\
<br />
<br />Owner's Name
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />7eP'^"1 r "" I \ \ ~
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I}J \J\
<br />
<br />JOB ADDRESS
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<br />1S-~0'1
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<br />I PARCELlD#h \'dJo <1\ 001 0 \ 3~()O (X) sO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />LZI ADD/ALT D SIGN D MOVE D
<br />cz::J REPAIR
<br />o COMM D
<br />o FRAME D
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<br />OS'lc\V IN /12GM-o\J().!t sf ~"""""-~",,,s. ~d. \ If 01 <> Df ~\()L\L-S
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<br />BUILDING SIZE SQ FOOTAGE I HEIGHT I
<br />1111111111111111111111111111111111111111111111111111 , , . , , ' 1111111111,111111111111,.11111111111111111111111111111.111111 . , ' 111111111111111111111111
<br />
<br />SUBDIVISION
<br />
<br />LOT #
<br />
<br />DEMOLISH
<br />
<br />~ BUILDING 1$ ~cro I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING 0
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D BLOCK
<br />irAS\-C. \ \
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
<br />
<br />j'Jo C
<br />
<br />----
<br />
<br />n
<br />VALUATION OF MECHANICAL INSTALLATIOI'r Lo{)'-(
<br />- 11()c.A.
<br />
<br />b{: CC'n.-h~~
<br />u...../cw.....~
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />175l-~
<br />
<br />
<br />
<br />
<br />COMPANY I\{L'V~\C..~ ~\J\l ~
<br />REGISTERED IG> N I FEE CURRENT ~ N
<br />
<br />"7d-=t 5-=td-. S') ~ 'J.... 1\ \ ~ License #
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<br />
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<br />
<br />ELECTRICIAN
<br />SiGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />FEE CURRENT
<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 />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />1111111111I11I11111111111111111111111111111111111111111111111111111111111I11111I111111111111111111111I1111111111111111111111111111
<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 onsite, 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 onsite, 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 />DI~~~ti~~~':' . . . . , . . . . , . . . , . . , , , . . , , , . . . . . . . . . . , , , . . , , . , , . . . , , . . . , , . . . , , , . . , , , . . . , , . . . . . . . , . . , . . . . , , , . . . , , . , , . . . . . . . . . , , . , . . . . , . . . . . , . . , . . . . . . . . , . .
<br />
<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)
<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 (Plol/Survey/Footage)
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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