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<br />813-780.0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax.813-780-0021
<br />1~30. '-\ !,3o
<br />IZ-lp _. t..o"c~
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<br />Date Received
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<br />
<br />'f~
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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 />/ Owner.s Name
<br />
<br />/Owner's Address I 5-5-'1'1
<br />Fee Simple Titleholder Namel
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<br />23 rd
<br />
<br />Yt
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<br />/OB ADDR.ESS
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<br />2. S r cf S' f
<br />
<br />I
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<br />NEW CONSTR D ADD/AL T D
<br />INSTALL D REPAIR
<br />SFR D COMM D
<br />BLOCK 0 FRAME D
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<br />P L-{.+-tl 'V') 1'~ S' he.J ,
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<br />BUILDING ~E I 10 rX t ~ I SQ FOOTAGE I ( lo C' HEIGHT liD /
<br />TIIIIIIIIITIIIII'" "111" 1"'111111 I I I 1111' 111111111111111111111111111111111111. 111111111111111111111' I 1'111111' 11111111111111111111111111111I III
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<br />Fee Simpll! Titleholder Address I
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<br />I LJS-lf 7"
<br />.
<br />
<br />I
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<br />2- lie /15"
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<br />5s,-yL
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<br />LOT #
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<br />WORK PROPOSED
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<br />E3
<br />D
<br />D
<br />I
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<br />PARCELID#Ua-dU?~( - DadA. .60,00-003..0
<br />10BTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />SUBDIVISION
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<br />DEMOLISH
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<br />PROPOSEID USE
<br />TYPE OF C:ONSTRUCTION
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />./ DESCRIPTION OF WORK
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<br />0 BUILDING ,/ 1$ ~ I VALUATION OF TOTAL CONSTRUCTION
<br /> 2.. /Pi.I.-
<br /> /
<br /> ,
<br />0 ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY D W.R.E.C,
<br />0 PLUMBING 1$ I
<br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />0 GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
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<br />11111111111
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<br />BUILDER /
<br />SIGNATURIE
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<br />COMPANY
<br />REGISTERED
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<br />~ GUU n..su.....
<br />I Y I N I FEE CURRENT
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<br />Y/N
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<br />Addrelss
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<br />License #
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<br />ELECTRICI.AN
<br />SIGNATURIE
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<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br />
<br />Y/N
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<br />Address
<br />
<br />PLUMBER
<br />SIGNA TURJ:
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Addrel;s
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Addre!is
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />License #
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<br />11111111I11111111111I111111II11111111111111I111111111111111II11111111111111111111111111111111111111111111111I111111111111111111111
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<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 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:ii~~~ti~~~': . . . , , , . . . . , , , , , . , , , , , , . , , . , . , , , , , , . , , . . , . , . , . . , . . . , . , , . . , , . , . , , , , , . . , , , , . , , , , . , , , , . . . , . , , , , , , , , . , , , . , , , , . . . . , , , , , , , , , . . . . . , . . , , . . , , . . , .
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<br />Fill out application completely. / f\'\ anu...-C S ~~-S _ 5h>d
<br />Owner I~ Contractor sign back of application, notarized ~ 'J=.n \Rs. ~.... vvrt .
<br />If over $2500, a Notice of Commencement is required. (AlC upgrades over $5000) . -s-h\ \0...-\-\ ~V. .. 'S
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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 GOUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Addres;s
<br />111111111111111
<br />RESIDENTIAL
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways.Not over Counter if on public roadways..needs ROW
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