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<br />Date Received
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />813-780-0020
<br />
<br />Owner's Name 4.J ,"[ L I;; /Yl m u ~
<br />Owner's Address I .5 5 J f II#- sr. z~;' y,.z /11 l L -5
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />5/9/Y1~
<br />
<br />LOT #
<br />
<br />/3
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />PARCEL 10# I /1 :l G. .:21 () (j 10 / ) 70 (J
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />SUBDIVISION
<br />
<br />O/3CJ
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />B
<br />D
<br />D
<br />I vI;O 9 ,(jt- oe:-
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />5e/l. t/" C ("
<br />
<br />HEIGHT I
<br />
<br />OTHER I
<br />lot>"-
<br />
<br />I
<br />I
<br />.:200~'1
<br />
<br />o. ti. ECECr/l/Cfi(
<br />
<br />'To
<br />
<br />BUILDING SIZE
<br />
<br />SQ FOOTAGE I
<br />
<br />TIT..II. 11111111111111' 'I III "1' 1II1I111II1II1111111111111 "llllf"1 "1 11111. ~ 111111111'1111111111111" III r'fllllllll' 1III11111IIIII11111111111111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />( ~
<br />VALUATION OF TOTAL CONSTRUCTION t> () 0
<br />
<br />AMP SERVICE ~PROGRESS ENERGY
<br />;<66;t:).
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1111I11111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />D
<br />D
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />,4;3~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />IfC# /300 l.:f J" 3 I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />1I111111I11111111111111111111I111111111111111111111111I11111111111111111111111111111I11111111111111111111111111I111I11111111111111
<br />Attach (2) PIDt 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 on site, 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 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 />Di~~~ii~~~': ' . . , , . . . , , , , , , , , . , . , . . , . . . . . . , . . , , , , , . , , , , , , , , , , , , , , , , , , , , , . , , . . , , , . . . , , , , . , . . , , , , , , , , , , . , . , , , . , , , , , , , , , , . , , , , . , , . . , , , , , , , , , , , , , . , , , , , ,
<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 Attomey (for the owner) would be someone with notarized lelter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AJC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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