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<br />813-780-0020
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<br />City of Zephyrhills Permit Application, it
<br />Building Department
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<br />t-~~'l
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<br />Fax-813-780-0021
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<br />It'''5~ 1
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<br />Owner's Name , I
<br />Owner's Address I 7 D'5'n 6A.(....L- J3 l-.V 1) .
<br />Fee Simple Titleholder Namel SAME
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<br />Fee Simple Titleholder Address I
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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 />Date Received
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<br />SUBDIVISION
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<br />I
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<br />~ NEW CONSTR r-=J ADD/ALT 0
<br />DO INSTALL ~ REPAIR
<br />PROPOSED USE SFR ~ COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
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<br />DESCRIPTlONOFWORK !AiJj\ CAN!?""I 7() No/S"I-I"'5tf!.E toNe ~~ hbsj)'IT4L-
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<br />BUILDING SIZE I I SQ F:OTAGE 1 ~I HEIGHT -- .
<br />11111'1111"111'111111111'11111111'11111111"'1111'1111'111111'111'11"""'111'1111'11'111111"111111111111'tlll,rlll.r,IIII'IIII,III"'I".111111
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<br />I'5ME
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<br />LOT #
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<br />JOB ADDRESS
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<br />PARCEL ID#136 -- 2-5-- 21-cpl () --l 0500- OO{JO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />OTHER
<br />STEEL
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<br />~
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<br />OTHER I
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<br />D
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<br />1$ 2-DO, (JDD
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<br />,
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<br />D ELECTRICAL 1$ I'D; ODD
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<br />D PLUMBING 1$ z:;; IJtJ()
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<br />D MECHANICAL 1$ 1'l/4
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<br />D G.AS ~ ROOFING
<br />FINISHED FLOOR ELEVATIONS I
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<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY D W.R.E.C. ,~
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<br />q-.JCX_ - CX', 'if .p", \l'hr'-
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />~~.
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<br />SPECIALTY 0 OTHER
<br />FLOOD ZONE AREA DYES
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<br />DNO .312"'07 j\.k.-t,.('",'",c\ lxsc~
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<br />f:J77.!JO
<br />BUILDER
<br />SIGNATURE
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<br />
<br />l) 1 License #
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<br />COMPANY ~ F L..6- L 'TP-.l C
<br />REGISTERED ~ xP N-I FEE CURRENT
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<br />License # I
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<br />COMPANY
<br />REGISTERED
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<br />I
<br />~0~~
<br />Y / N 1)0'
<br />.~ I
<br />
<br />Address
<br />l(r ': ~
<br />'( ; UMBER
<br />SIGNATURE
<br />
<br />Address
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<br />11 -50 I
<br />~ 1:[l?C~RICIAN
<br />SIGNATURE
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<br />I
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<br />~
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<br />
<br />COMPANY
<br />REGISTERED
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<br />~3J
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<br />Address I
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<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
<br />111111111111111I11111111111111I1111I111111111111I1111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111
<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 />Y/N
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />SIGN PERMIT
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<br />DI~~~ii~~~': ' , . . . . , , , , . , , . . , , . . , , , . . . , , , . . , . , , , . . , , , . . . , , . . , , , . . , . , . . . . , , . . . . , , , , . . . , . . , . , , . . . . , , , . . . . . , , , , , , . . . . , , , . . , , . . . . . . . , , , , , , , , , . . . . . . . . . . .
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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. (AlC 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 (Plot/Survey/Footage)
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<br />,~~~.
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<br />Driveways-Not over Counter If on public roadways..needs ROW
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