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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />813-780-0020
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<br />Date Received
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<br />~5 gh s,\ 2Cft\-i~~\\\~ ~L33~ifz LOT# lLe- I
<br />PARCEL ID#U 2-- 2~.. 21- oO<ftJ... {)() ~m- 01 flu I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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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 L
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<br />Owner's Name
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />I~\'t
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<br />SUBDIVISION
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<br />D NEW CONSTR r=J
<br />D INSTALL D
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<br />PROPOSED USE D SFR D
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<br />TYPE OF CONSTRUCTION D BLOCK 0
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<br />DESCRIPTION OF WORK LRf: -1/JcJ'tTe mEld
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<br />BUILDING SIZE I I SQ FOOTAGE I HEIGHT I
<br />, ~ . . I I , , . I . I I I II , I , . . I I I II , . , I I t I , , 11 I IIII I , I , , . I I II I I I I , . I I II I . I II I I , II II I I I I , , I I I II I . I II , I I r I II , , , I II III I I , r . 1 I , II , I I I , I r I I I I I , I I I I I II I . I I I I I I , I
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<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />D BUILDING
<br />~ ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />1$ I
<br />1$ I
<br />-roo e<J
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<br />1$ I
<br />1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES [=:JNO
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<br />111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE IOOA
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<br />PROGRESS ENERGY
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<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
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />
<br />License #
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<br />Address
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<br />I bHtJemkJ~ c:u:d/2lC' ~,
<br />I Y / N I FEE CURRENT I Y / N I
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<br />License # It;T.i 13a::bl957
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/ N
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<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/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
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<br />COMPA~Y
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
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<br />License #
<br />11111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111II1111
<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 w/ 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 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.
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Dl~~~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. (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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