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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />OWner's Name t. EN.
<br />Owner's Address I '00 AI. W4srS#oIZE:l~ 1/0"# ~()D ..,-"..,,',,
<br />Fee Slmpl'e Titleholder Namel
<br />
<br />
<br />
<br />~ ' . ~' ;G' < .
<br />
<br />Date Received
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />6383
<br />I Ell, 'M/o f'J".e.k...
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />6L-Db 2-D
<br />; ~ ...- \v ,". - (
<br />
<br />RDl9b I 'Z~"'-"IjI~J/IUJ..'&t..73 S'IID I LOT # 1/93
<br />
<br />PARCEL ID#I f),S -:J'-:l/ - ()~3t) -f!)()()Oo- /930
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />g 1I1/J/E
<br />
<br />SUBDIVISION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />~
<br />D
<br />I8l
<br />I N~w
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />Coli/oS -rItAlCn D N
<br />SQ FOOTAGE I
<br />
<br />- rOWN lIol1?ES
<br />
<br />HEIGHT I e>?S-ro"d I
<br />
<br />0"'" ~~,~~;~~"""'" i;" '';;~' ~;~""..... i"'" ~~:~~~;~~ '~~ ~~;~ '~~~~~;;:,~~"""""""""""""""""""'" ,
<br />D ELECTRICAL 1$ .3 t/ t/ 0 I AMP SERVICE ~ PROGRESS ENERGY 0 W.R.E,C,
<br />D PLUMBING 1$ I.{ 3::?S I
<br />D MECHANICAL 1$ i/;l. ~S- I
<br />D GAS D ROOFING D
<br />
<br />BUILDING SIZE
<br />
<br />'(~3\
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />qo, I~
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />Address
<br />
<br />
<br />LENA//I~ floN/E..s
<br />I(YJ N I FEE CURRENT ICYY N I
<br />
<br />License # I Cae 1':?5'S7S 1
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />J8c, GLEC7"rele:....
<br />I(t) N
<br />
<br />FEE CURRENT
<br />
<br />ItYlN I
<br />
<br />License # I t:. C I :3 00 lee"
<br />
<br />.fUllGMIf'" ~VRr 8/1'I?
<br />FEE CURRENT / N
<br />
<br />License # I CPc.. 01.//'72 /
<br />
<br />13#~()III€"r ~VMOIAl~.1 h4 '-16-.. 9";tfc.
<br />N FEE CURRENT 7 N
<br />
<br />License # I CI9C OS9 D(pZ
<br />
<br />. OTHER C, ST~f!,'IN(, ~lJlllA'" '€oo F" u6-.1 :r",c. ,
<br />SIGNATURE N FEE CURRENT Y N
<br />
<br />Address ,/{2.11 S'I/Mt.bllE 'LII" S'I*-IN~IItLL ;::t. 3I/HJ'7 License # ICC-COS"?99/ I
<br />1I111111111111 , 1111111111111111 , 11111111111111111111111111111 , 111111 , 11111111111111111111111111111111111111111111111111111111III i IIIi 111I i II1I1 ill
<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 Plans wI Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge 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 onslte, Construction Plans, Stonnwater Plans w/ Slit 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 />Address
<br />
<br />33b Ie;
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />
<br />
<br />Address
<br />
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<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 . . . . oJ 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 with notarized letter from owner authorizing same
<br />
<br />'OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs SElv,v.w:I1__,.... Service Upgrades AlC
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<br />Driveways-Not over .90Ppter if ohpubllc'roadwaY!l-:.n~8<lsROW
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<br />
<br />Fences (Plot/Survey/Footage)
<br />
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