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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 />
<br />Date Received
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<br />
<br />t.. M
<br />Owner's Address I {,oo AI.
<br />Fee Simple Titleholder Namel
<br />
<br />Owner's Name
<br />
<br />I
<br />I
<br />I
<br />
<br />RDQD, 'Z~"/lj'~III'U /.&(,33$t,Io I LOT# 1/9tf I
<br />
<br />PARCELlD#1 ()3-~' -~ 1- &.:I3()--:-OOOOO-/9$1ol
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
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<br />
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<br />Wesrs#olZE ~~ Va ~ ~(jD .,-,,1ff,'1I
<br />
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<br />PROPOSED USE 0
<br />TYPE OF CONSTRUCTION I8J
<br />
<br />DESCRIPTION OF WORK I Hiw Co~.s""MC.17 D;v - -r'Owl\! lIol'YlES
<br />
<br />BUILDING SIZE SQFOOTAGEI '[53} I HEIGHT I ~ .s-rt:Jtt..Y I
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<br />I' '" I " '" ~~,~;~~ .., "'" 'I; ".~;~ '~';~ ' , , , , , , , , i ' ' , , , ~~~~~~:~~ '~~ ~~~~~ :~~:;;'~~;,~~' , .. , .""". , , , , , , " " '" '" , , , , , , , , ' , , , ,
<br />
<br />D ELECTRICAL 1$ 3'1 J./ 0 I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C,
<br />
<br />D PLUMBING 1$ '-I 3.:(5 I
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<br />D MECHANICAL 1$ ~;1. f'5" I
<br />
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />
<br />PLUMBER 1'''11' GM",J ~(Nn 16 /1'1 ~
<br />SIGNATURE FEE CURRENT N
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<br />Address License # I C,cC" t:J 'II '72 I
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<br />MECHANICAL 8~()IIIF"'IiIlM(JIAlI-,. /hI'f77N6-~ 9" ",C
<br />SIGNATURE N FEE CURRENT N
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<br />Address License # I C,i!/C OS90(p2.
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<br />, OTHER COMPANY C. Sr.. f!1-/N" ravll '-1"f .1<00 lutr ~ rNC. .
<br />SIGNATURE REGISTERED N FEE CUR~ENT Y N
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<br />Address 1.12/1..sf/M/.. ' F8LI/() .S'I*-IN~lItt.l- rt 3YHJ9 License # Ice"'C05'?99/ I
<br />11'11'1' 1I11111111111!!1I ''''lIllllllll!!IIIIIII!!I'IIIIIIIIIIII!11 I IIIIIIIIIIIIIIIIIII!IIIIIIIIIIIIIIIIIIIIIII I II 1\ 1',1.111111111. i I11I i III i I111I i II
<br />RESIDENTIAL Attach (2) Plot Plans: (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Pennlt for neVi constnJc;tlon,
<br />Minimum ten (10) working days after submittal date, Required onslte. Construction Plans, Stormwater Plans w/ Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Pennlt for subdlvlslonsl1arge projects
<br />COMMERCIAL. Attach (3) sets of Building Plans; (1) set of Energy Fonns. R-O-W Pennlt for new construction.
<br />Minimum ten (10) working days after submittal date. Required on site, Construction Plans, Stonnwater Plans w/ Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Pennlt for all new projects, All commercial requlrementsmustmeetcornpllance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans. .
<br />....PROPERTY SURVEY required for all NEW construction,
<br />
<br />Fee Simple Tltlehold.er Address I
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<br />(p 3Jl
<br />lEI '-/M/a /191l.k...
<br />
<br />JOB ADDRESS
<br />
<br />gil/J /E
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<br />I
<br />B
<br />D
<br />D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SiGNATURE
<br />
<br />Address
<br />
<br />BL-Db- '20
<br />
<br />1\\ .,l
<br />
<br />I ~
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER I
<br />
<br />DEMOlisH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />LEA/A/' /lit!. NoME..$.
<br />I & N I FEE CURRENT 10) N I
<br />
<br />License # I CB C 1':< ~S 751
<br />
<br />J 8 C. EL Ecr,-c I c:...
<br />I (j) N FEE CURRENT
<br />
<br />License #
<br />
<br />ItJ)N I
<br />lE.e /3 001 e 8 "
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<br />
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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 . . . . . -'J ~ 'I'-I"..I~"-I" ,..,~.:. -.' ,J -. ,.-.. . I . .oJ.. ".' 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 $5000)
<br />
<br />.. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />'OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs.Sl5.ar~....SelVlce Upgrades AlC
<br />. '~""""*~~'''''Il~;.,..,.....,
<br />: qs:.l$.tlc'~'''; t/~ "':;.)~Il..t. ,'''''''1 .
<br />Driveways-Not ~v~.r,:~~p:~r'.!t ol,!\~~~'~tf~e.o~~.fje~ASfROW
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<br />Fences (PloVSurvey/Footage)
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