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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Owner's Name ( ~d
<br />Owner'sAddress ItOq\::l-S~+nSt". N l~P~~l.U-
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />
<br />Fax-813-780-0021
<br />
<br />f 1olob
<br />
<br />Date Received
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />15 )1>?J s- bYD",-A (l') Ot-<.--
<br />trr e."..J~ t-vtob Ie. ~I
<br />
<br />LOT #
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK I'R "PI 0..<-<.., po,^,~ :c I <--" ve.p 10..< · -e -'" , "'{to) <-1.,V: l' ] ,~
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT _
<br />11111111111111111"11'11111'11111111111111"'1'11111111"'1""'1'11111111111111111111111111"11'111111111111111111111111111111111111"11111111111
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCELlD#IIO- 2.<OP 2-(. OOCD. 00 I t>D ~ CJCJ.:J0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />~
<br />D
<br />D
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />o
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />1$
<br />
<br />I
<br />1$ ~u l):?' I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'1111111111111I1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />lco
<br />
<br />OCJ
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIA..J \ r '- -~ \ l l\
<br />SIGNATURE'~~~
<br />Address !t>Obu}( 'Slo~ Zoph'1i hllb
<br />
<br />i=L
<br />
<br />License #
<br />
<br />I COMP"; +RJlTI"-- ~.e~.".-;,<u -U]<
<br />REGISTERED Y N I FEE CURRENT k Y) N I
<br />
<br />~?f)'U~ License # I Ec...I30o, ~$ .~
<br />
<br />I
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />111I111I111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111.111111111
<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 subdivisionsllarge 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 />DI~~~ti~~~': ' . , . . . . , , . . , . , , , , , , , , , , , . , . , . , , , . , , . , , , , . , . , . , , , . , . . , , . , . . , , , , , , , , . , , , , , , . , , , , . . , . , , . , , , . , , , , , , , , , . , , , , , , , , , . . . , , , , . , , , , , , . , , , , , , , , , . , .
<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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways.;needs ROW
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