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<br />8 '13-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />Date Received
<br />
<br />Phone Contact for Permittin
<br />
<br />Owner's Address
<br />
<br />~rJ~~~.~~ ll~~s1,
<br />5 Vo(V ') '" \fv(r- il" t> ..l
<br />
<br />
<br />Fee Simple Titleholder Name
<br />
<br />
<br />Owner Phone Number
<br />II z-i,zl I
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />38lc.Cp
<br />
<br />13u' ~.
<br />1
<br />
<br />B
<br />D
<br />D
<br />fr {c. c-f.- "wj~ DuJ., 2 '(0 ( .
<br />
<br />BUILDING SIZE I SQ FOOTAGE 1 I HEIGHT
<br />
<br />111111111111111111111"111111'11"1111111"1'-"'111111111"111111111111111111111"111111111111111"1111111111II1111111111111111111111111111111111
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ 2~9)'~ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111I1111I11111111111I111111I111111111111I111111111111111111111111111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />SUBDIVISION
<br />
<br />PARCEL ID#I
<br />
<br />WORK PROPOSED
<br />
<br />E3
<br />D
<br />D
<br />I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />LOT #
<br />
<br />II .
<br />
<br />'-b.2. J -oQlo ~ D 3 200 -'OZ,.OIQ
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />PLUMBING
<br />
<br />~
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />:> '7 ? ~ B KC~5 tiC (!.D)J-,L 2.€-p~
<br />
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />I1111I1111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 wI Silt Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsions/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 />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />
<br />II.I~ ~ (
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License # I
<br />
<br />I C~ rca-~ PIle' ~ (NI';J L"'~
<br />I Y I N r FEE CURRENT I Y I N I
<br />
<br />License # I CI1C. 0 ~p- b ''7 .
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<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 Attomey (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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public raadways..needs ROW
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