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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />tdEsrs#o1ZE :JLV() 11 ~tJD ~""I'''
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<br />
<br />
<br />1
<br />Date Received
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<br />OWner's Name
<br />
<br />JOB ADDRESS
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<br />Fee Simple TItleholder Address I
<br />
<br />6337
<br />I tll../M/o /141l..k..
<br />
<br />~
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION IKI
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<br />DESCRIPTION OF WORK I NEW Col(/.s..,.~c:n ON - -rOwNllol1?ES
<br />
<br />BUILDING SIZE SQ FOOTAGE I . /.3 7/ I HEIGHT I e? Jr,,~ I
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<br />o 11111 ~~I':~;~~ ' 111111' I f~ ' II;; ~'~I; ~ II , III , I ' i ' 111I ~~~~I~~;~I~ r~~ ~'~~~~ ~~~~~~~~~I~~' ' . , , I . . '111111111111111 . . . . , . . 11111111111
<br />o ELECTRICAL 1$ .3 i/ t./ 0 I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C,
<br />o PLUMBING 1$ '-I3:? 5 I
<br />o MECHANICAL 1$ ~;l.~S- I
<br />o GAS D ROOFING D
<br />
<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />8L-:D& ~o
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<br />ROllI:> I "Z~,I1/1j1~I/Iu..J ~ ,&(..33S~ I LOT# 1/9 /
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<br />PARCEL ID#I tl "3 -,,2" -:l / - {) ;J 30 - (!) aJO()- 19/0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />g II/IJ/E
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<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />, ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address'
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />FINISHED FLOOR ELEVATIONS
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<br />DYES
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<br />DNO
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />LENA.! Il'/!e f!oME..s
<br />I(J) N I FEE CURRENT ~ N I
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<br />License # I c.ae 1:<5'575 I
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<br />IJBc E''-ECT~/c:....
<br />~Y') N I FEE CURRENT I(~f N I
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<br />License # I E. C / :3 00 / e s "
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<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />~lIlGM"N ~l/ . 8/"'?
<br />FEE CURRENT 1 N
<br />
<br />License # I C~G oll/?'2 I
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<br />()NtFr I'itlMOIAl~/ IhI'f77N6-/ 9' ",c.
<br />N FEE CURRENT I N
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<br />License # I C-'1C O.sgD~2.
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<br />'OTHER COMPANY C. Sr~f!,LlN(,. ~lJlIL.4 ~ ,€QO ~/utr/ :lNC. ,
<br />SIGNATURE REGISTERED Y N FEE CURRENT N
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<br />Address 112./1 'sf/OAt. 'Lilt:) S'I*-IN~Mt.L ,q. 31/'0'7 License # ICC"'COS"?99/ I
<br />III " I " 1I1111111111111111I " 11II1111111 " I1I11 " 11I11 " II " 1I1II111 , 11I1111111111111III1I11I11111I1II1II111111111I1111I1111111I111111111 i II1II i II
<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 onslte. Construction Plans. Stormwater Planswf Silt Fence Installed,
<br />Sanitary Facilities & 1 dU,mpster; Site Work Permit for subdivisionsflarge projects
<br />Attach (3) sets 9f BUilding Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10)worklng days after submittal date. Required onslte. 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 />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />
<br />
<br />Address
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<br />
<br />COMMERCIAL,
<br />
<br />SIGN PERMIT
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<br />I I I . I I . . I . I . I I . ~ I I . I . I . I I . I I I . I I I I . I I I I I I . I I . . I I I I . . I I . . . I . . . . . . . . . . . . . I . . I . I I I I . . I . . . . . I I I I I I I . I I I I . I I I I I I . I I I I . I I . I I I . I I I I I I I I I I I . . . . . I . . . . . . . . I
<br />Directions: .
<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 wtth notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />ReroofsSew.~~._~..,..._~ervice Upgrades A1C
<br />"""""...... .1' .-'" -.~,~... '-' ..,.... '.<. . ..,''''<.I,......,'''......
<br />
<br />Driveways-Not ov~F~~l,it~;' If of{pubrtc'rb~dwaY{~~ildsROW
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<br />Fences (PloUSurvey/Footage)
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