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<br />813~780-0020
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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 />Date Received
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<br />t+-ne. ''Z-/+'II\S LOT# 1503J:364J
<br />PARCELID#I ~Y-35 -a I-013D-oocoo- 50YO I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
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<br />2:\'\,\'S. ~L.-I
<br />.
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<br />35SLt'1
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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 />5-/1-07
<br />Owner's Name K',c...' C...C d..
<br />Owner'sAddress 1~7l, IS< 1..1) "d'\S
<br />Fee Simple Titleholder Namel
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<br />H-ue.
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />13') ) ;~L:t
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<br />SUBDIVISION
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<br />Ide LA Kn (lf1
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<br />WORK PROPOSED
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<br />D NEW CONSTR c=J
<br />IxJ INSTALL D
<br />IX] SFR D
<br />D BLOCK D
<br />I frb'O, \~ \-\oC\\e... CSd- LLr
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER lrY)nhi Ie i-!t'Jm€ ,I
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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<br />~~:~~II~~I ~:~~, I , , I~I~ f? ~ ' , . III , II .III ' , 1 ~~ ,~~~~~~,~ II, , ! ;?~7:'111 . , , , II ' ! 1111 ~~~~~~ 11111' , , 1111111111111111 .1, . , I ' 111111111111111111
<br />
<br />g-
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<br />1$ 4, 750 I
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<br />1$ J, 7;)00 I AMP SERVICE rtJ PROGRESS ENERGY D
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<br />1$ iolO.co I jJJt ;'~/~_
<br />c:r:;;r- MECHANICAL 1$ 4, Dce> I VALUATION OF MECHANICAL INSTALLATION :~1\1f:trJ4ff.j7'fJ -11' 1
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<br />D GAS D ROOFING D SPECIALTY D OTHER ~\itV-~
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES JXjNO
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<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />~
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<br />PLUMBING
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<br />ELECTRICAL
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<br />W.R.E.C,
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<br />BUILDER
<br />SIGNATURE
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<br />COMMERCIAL
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<br />I L I Ul'-~ '([ ~\...
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<br />Address 3C1 e.u.u. 6 \. L
<br />ELECTRICIAN I LL~., " K'I .--~ r '(' b C' '\.. I
<br />SIGNATURE . ,-l\~\....l~('f\! .
<br />Address A;;J3 w. mm~n'{LL6.1vd, I-O~
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<br />~~~::r~~E I ~t~:LC&(r*~c2.Q '-- I
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<br />Address 139m 5\ftJ:t("+ ~~H, I~
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
<br />11111 I 11111111111111 I 11111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111I111111111 I 11111111111111111111111111
<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 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 />I D \Itr
<br />I Y/ N I
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<br />COMPANY
<br />REGISTERED
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<br />I Y/N I
<br />License # I'TH- - OOOO~q4
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<br />License # I ~5()/Y)(,LJlD U
<br />L_L-0- I
<br />FEE CURRENT I Y / N I
<br />License # I X If - (J 000 'it LLJ
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<br />N I FEE CURRENT rt!J N I
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<br />FEE CURRENT
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<br />COIo?yI,.~2.J..3r
<br />COMPANY
<br />REGISTERED
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<br />~(y)I
<br />Y / N I
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<br />REGISTERED
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<br />License #
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<br />
<br />COMPANY
<br />REGISTERED
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<br />FEE CURRENT
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<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)
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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 NC Fences (Plol/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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