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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
<br />
<br />
<br />
<br />Owner's Name ,l<..EE GrJrN S Lm
<br />Owner's Address 1109 I;L 5{P-tb. S.,.-. N
<br />Fee Simple Titleholder Namel
<br />
<br />f.{Mple Tu(~
<br />
<br />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
<br />I EfDllc ex- (lA'1 b~.k_
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />
<br />s+-. 2e..pn\...j( 'h, I \~
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />PARCELlD#1 (0- -UO-1-l- 0000'- 00 (00.- GODO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />FL.
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />SFR
<br />BLOCK
<br />
<br />~
<br />~
<br />COMM
<br />FRAME
<br />
<br />00
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />B
<br />
<br />PROPOSED USE 0
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK l=R€f\ Cl.J' Pi"H~ pole> LB'nj J'" -h" '\ ~ Jl f Mj i\ T '
<br />
<br />BUilDING SIZE _ SQ FOOTAGE I J HEIGHT I J
<br />TIIIIIIIIIIIIIII'IIIIII'IIIII' '111111111'11111111111 ~ 111111111111111111111'" 1111' 1'1"1'11111111"111111111 II 11111'1111' 111111'111111111'1111'111
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />1$ I
<br />1$ Sao.ou I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />1111II1111111111111111111111111111111111111111111111111111111111I1111111I1111111111111111I1111111111111111I1I1111111111111111111111111111111111111
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE l (:)0
<br />
<br />C5Zl
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />I
<br />
<br />fL ~~'1- o'&1l.
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License # I
<br />
<br />fRQ.Q.S0 Et e Ltl-i (oJ IN c.. .
<br />I Y I N I FEE CURRENT I Y I N I
<br />
<br />License # I ~'?::f:JO \ '~.$ '3
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<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 />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />11111111111111111111111111111I111111111II1111I1111I11111111111111111111111111111II11111111111111111111111111111II1I111111111111111
<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 on site. 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 />i:ii~~~ti~~~': . , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , , , " ' , , , , , . , , , , , , , , , , , , , , . , , . , , , , , , , , , , , , , , , , . , , . , , , , , , 1
<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 (PloUSurvey/Footage)
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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