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<br />813-780-0020
<br />( 1
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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 />Date Received
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />WEsrsNoIZE :1~I/() -t# ~aD '1/1",,/11/
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
<br />
<br />(p~'7
<br />I Ell. 19 NO //4""k..
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<br />~
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<br />PROPOSED USE 0
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<br />TYPE OF CONSTRUCTION 1&1
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<br />DESCRIPTIONOFWORK I NEw CoIVS-rtevC.17 DN - -rO(,(JNlloA'7ES
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<br />BUILDING SIZE SQ FOOTAGE I '~5.3 I I HEIGHT I Dl JTt1~!:f I
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<br />I J I.. r r T 111111111111'11"".'.." 11'111111111111111' II'''''' r,.,., "111"11." T' "" 1'1'111'" I r 111111111"'" T'" "'" r I' r, t., I r 1'1"111111111111111
<br />o BUILDING 1$ ~/) / <"'..t"'I
<br />. .;/ UI.Jf,J VALUATION OF TOTAL CONSTRUCTION
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<br />o ELECTRICAL 1$ .3'-1 t./ 0 AMP SERVICE ~ PROGRESS ENERGY
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<br />D PLUMBING 1$ Lf 3.:(5
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<br />D MECHANICAL 1$ ~;J.~S-
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<br />D GAS 0 ROOFING
<br />FINISHED FLOOR ELEVATIONS I 90 I / S'
<br />
<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />B L"Db- 2-D
<br />
<br />RrJ/ll:> / -Z~,t1~Y~J/It.U ~ .&t..73S~ I LOT # 119ft,
<br />
<br />PARCELID#lo3-"?b-.2/-I):230- 00000-19' 0
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
<br />SIGN D MOVE 0
<br />
<br />.tfII" /oS / E
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />ADDIALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />I
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
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<br />BUILDER COMPANY LE/II~ 'lit? NoN/E..s
<br />SIGNATURE REGISTERED 1(f)N I FEE CURRENT ,@N I
<br />Address LIcense # I CBC 1~1S'S7S I
<br />ELECTRICIAN ..I Be ci. ECTrt:.1 c:.....
<br />SIGNATURE IN)N I FEE CURRENT V'Y)N I
<br />Address LIcense # It:'CI:300/8S'='
<br />PLUMBER COMPANY 1..4~vte SUllGMIf,.,J ~VRr 8/1'1?
<br />SIGNATURE REGISTERED N I FEE CURRENT I (]7:N I
<br />Address --r I'U'1If tn/I rt. LIcense # I Cpt:., o'l/?2 I
<br />
<br />
<br />
<br />MECHANICAL N6- / 9' '" C.
<br />SIGNATURE N
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<br />Address License # I C /Ie 059 o(P 2.
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<br />. OTHER COMPANY C. Sr~eL-IN" ~\JAI-t~ '€oo t:.. u~~ :I'Vc',
<br />SIGNATURE REGISTERED / N FEE CURRENT N
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<br />Address '1211 S'J/IJ BJ.III!J -S'I*-IN6-lIIu. rt. 3'1~()'7 License # I CC-C o "5?99 / I
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<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Attach (2) Plot Plan~; (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 Slit Fence installed.
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivislonsllarge projects
<br />COMMERCIAL. 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. Storlnwater Plans w/ Slit Fence installed.
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />H**PROPERTY SURVEY required for all NEW construction.
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<br />11..11...11111111.1111111...1.111111111111111..1111..........1..1111............1111111...11111...111..1111.11......111.....111.....111...........
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs SeW.tl1~........,..".serylce Upgrades AlC
<br />-,_....,....,._..<..,~"'..,...."",:,..." ..~...~..~Jll><..:"-
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<br />Driveways-Not ov~}~a;~Ht~;'lt oi{pi.ibn6'rbiidWl!iy~~:hEl~sROW
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<br />Fences (Plol/Survey/Footage)
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