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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />W4srs#oIZE :JJ..vo711 ~~D "1Atff;'1/
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<br />Date Received
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<br />Owner's Name
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />(p 3;l ,
<br />I tU.J9NO ~Il..k.
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION 1&1
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<br />DESCRIPTION OF WORK I HIP"; CoIV.s-rMcn DN - '()wl\! lIodJES
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<br />BUILDING SIZE SQ FOOTAGE I . t 53 \ I HEIGHT I :? S-rOIL-~ I
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<br />0' , , , '~~,~~:~~ . . . , " "'i;" ..;;~' ~';~ ' , , " , ,.. i"" '~~:~~~:~~ '~~ ;~~~ '~~~~';;.~~~,~~' , , , , , , , , , , , ",." " , , , , , , , , , , , , , . . . . , , , , ,
<br />o ELECTRICAL 1$ .3 L/ '-I 0 I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C.
<br />o PLUMBING 1$ I..( 3.::(5 I
<br />o MECHANICAL 1$ tI:1.~S- I
<br />o GAS D ROOFING D
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<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />I
<br />B
<br />D
<br />D
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<br />BL. Db- 2-D
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<br />RD,9l:> I 'Z~I'/lY~#I'(...J, '&t."3S~ I LOT# 1/95
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<br />PARCELlD#lo3-~' -:;. /- O,J.30 - (f)oaoo- 1950
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />g II'IIJ/E
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<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />(
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<br />SUBDIVISION
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />tlo, /~
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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 />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />LENA.! ,/Je NoN1E.s
<br />I@ N I FEE CURRENT I (YYN I
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<br />License # I CBC/':<5"S7S I
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<br />
<br />BUILDER
<br />SIGNATURE
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<br />Address
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<br />..IBc. ELECT~/C-
<br />IC:)N
<br />
<br />FEE CURRENT
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<br />I(Y)/N I
<br />It:'C/:3oo/SS'='
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />~II('GM"^, ~(/Rr liNt?
<br />FEE CURRENT Y I
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<br />License # I C,cC, 0'1/72 I
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<br />13#V()IIIF'T" I'i"MO/A1~/ A4
<br />N FEE CURRENT
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<br />
<br />Address
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<br />
<br />MECHANICAL
<br />SIGNATURE
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<br />Address License # I CAe OSgO(pZ
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<br />. OTHER C. Sr~~t.llJlr ~lJlIl..I~ .eoo ~/AJ6-~ :rNC,
<br />SIGNATURE N FEE CURRENT N
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<br />Address '1211 ..sIlML 'IN BJ.lltJ S'~/N~ /It" rt 3'1'0'7 License # I CC-C 05"'1'99/ I
<br />1111111/11111111/111/111/1111/1/1111111111111111" I " 11111111111111111111111111111111111111111111111111111111I11II11111I11111I1 , i 1111 t 111111111111
<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 subdlvlslons/large projects
<br />COMMERCIAL. Attach (3) sets of Building Plans; (1) set of Energy Forms, R-O-W PermIt for new construction.
<br />Minimum ten (1 0) working days after submittal date. Required onslte. Construction Plans, Stormwater Plans wI Slit Fence Installed.
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercIal requirElments must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction,
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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 I I . . I I . . I . . I I . . I I . . I . I .. . . . . . I
<br />Directions: .
<br />Fill out appllcallon 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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />ReroofsSeW.w~._..",,, Service Upgrades NC
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<br />Driveways-Not ov~~ ~WpW~r~ If of.(plibn6'rbiidway~~:h~SROW
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<br />Fences (Plol/Survey/Footage)
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