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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received :5 - ~2-- - D 1
<br />
<br />
<br />Owner's Name l2..o.(;e1'1 -r <f
<br />
<br />Owner's Address I J 103cf
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />I!UJ../w"f
<br />.#t/e/Jv-e
<br />
<br />
<br />Fee Simple Titleholder Address
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />
<br />SFR
<br />BLOCK
<br />
<br />I
<br />
<br />B
<br />o
<br />o
<br />.J rOILAd' ~c /
<br />
<br />SQ FOOTAGE I
<br />
<br />2~/~rQ/I pi
<br />PARCELlD#1 /J
<br />
<br />33S$lcL
<br />rJ..(g -tU - ()C) f) j} - O~OrJ- OO/e}
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />,s (iJU
<br />
<br />as'
<br />
<br />r<...bore
<br />
<br />SUBDIVISION
<br />
<br />A/4...
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />MOVE D
<br />
<br />SIGN
<br />
<br />D
<br />
<br />DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />B
<br />D
<br />D
<br />I
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />
<br />!Xl
<br />D
<br />/1' I /'Otc..Ad
<br />
<br />I
<br />OTHER lIMO I
<br />STEEL ~ OTHER I
<br />
<br />WORK PROPOSED
<br />
<br />a.-60k
<br />
<br />I I
<br />
<br />11111'1'1'11111111111'1'1111111"11'1'11111"1111111"11'11111""'11"11111'1'1111"111'11111'111'11'111'111111111'11'11111'11"11""111'11111"
<br />
<br />BUILDING SIZE
<br />
<br />HEIGHT
<br />
<br />D
<br />D
<br />D
<br />D
<br />
<br />I
<br />I
<br />I
<br />I
<br />o
<br />FINISHED FLOOR ELEVATIONS I I
<br />1111111111111'~'I~IIIIIIIIIIIIIIIIIIIIIIIIIIIIII~I)~ll11111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />BUILDER ' } J. j" COMPANY
<br />SIGNATURE ~ ~Y-1UiJ REGISTERED
<br />
<br />Address I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />MECHANICAL
<br />
<br />1$ e), lf9S-.00
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />D
<br />
<br />II If(
<br />/L/I(
<br />
<br />AMP SERVICE
<br />
<br />c;tl
<br />
<br />PROGRESS ENERGY
<br />
<br />r:::J "
<br />....,...~.,..__L:=:::t
<br />
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />ELECTRICAL
<br />
<br />.---.---"
<br />
<br />-~-
<br />
<br />VALUATION OF MECHANICAL INSTALL.P;
<br />
<br />
<br />wk. eM-'S~
<br />
<br />PLUMBING
<br />
<br />GAS
<br />
<br />ROOFING
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />
<br />License #
<br />
<br />.j ;: '~t
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />
<br />1I111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111
<br />
<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 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Dl~~~ti~~~': ' , , I I I I I , , I I I , I I I . , , I I I , , I , I , I I , , , I I I I . , , I , I , , I I I , , I . . , , I , I I , . , , I I I I I , , I I . I , , , . , . , . , , I I I , , , , , , . . , , I I I I I . I , , . , , I I I I I I I , I . , . I I I . I I I I 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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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