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<br />Date Received
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<br />
<br />A-
<br />{ 0 fA 11. iA..Ooc( fJ I
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<br />Fax-813-780-0021
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<br />i\~~~ tV
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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Owner's Name
<br />
<br />Owner's Address 13 f 1- b ()
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />OWner Phone Number I
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I ::/8' '-I <f z.
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />E3
<br />D
<br />D
<br />bO S
<br />
<br />{o-fhh.UJoocl PI
<br />
<br />PARCEL ID#I 02-- 2. b - 2..\ - 02/0 - 0000 0 - /070
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE c=J
<br />
<br />LOT #
<br />
<br />3rs'f<lg-
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />c=J
<br />c=J
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />c=J
<br />c=J
<br />
<br />DEMOLISH
<br />
<br />I
<br />o
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />fi-f '\ \M\'c.rl;"'~
<br />
<br />DESCRIPTION OF WORK
<br />
<br />
<br />vrb /) 42-
<br />I
<br />
<br />1$ // 5&D ,OU
<br />1$
<br />1$
<br />1$
<br />
<br />SQ FOOTAGE
<br />
<br />
<br />HEIGHT
<br />
<br />BUILDING SIZE
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />I
<br />I
<br />I
<br />I
<br />
<br />D GAS c;q ROOFING D SPECIALTY c=J OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<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 />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />~,~HN"'~URE j~~- I :;.~~'::.~
<br />
<br />
<br />Address I33D (0 Sf!- G L ~ 5lftV f}IU;u License # Ie ( LOS- 7 t J 7
<br />
<br />1111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111
<br />
<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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsionsllarge 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 onslte, 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 />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~ti~~~': ' , , , , , , . , , , , , , , , . , , , , . . , , , , . , , , , , , . . , , , , . , , , , . , , , . . , , , . . . , , , , , . , , , , . . , , , , . , , , , , , . . , , , . . , . , , , , , , , , , . . , , , , , , , . , . , , , , , , , I I , , . . , , , , I , , , , , , ,
<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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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