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<br />813-780-0020
<br />
<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 Address
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<br />Fee Slmpl'e Titleholder Namel
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<br />W~srs#o1ZE :J~1/0" C(jD ~""/"
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<br />
<br />OWner's Name
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<br />Fee Simple Titleholder Address
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<br />I
<br />t, 3;1. !['
<br />I E".I9AJo I!u.."'-
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<br />&... Df= 2-D
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<br />PROPOSED USE D
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<br />TYPE OF CONSTRUCTION IKI
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<br />DESCRIPTIONOFWORK I )./Rw CoIV.$'1';t,.(Icn ON - r(:)wI\/HoA'1ES
<br />
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<br />BUILDING SIZE SQ FOOTAGE I . ( 5 3 I I HEIGHT I :1 J""t>~.!I I
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<br />I r II , IIIIII1IIIII1111 , I , 1 . I , II till' , 11 , " , 111 r , III1111 , III , III , II , , I . , r r . I . I r , , , , r II fll rill J I r I r IIIIIII , I , r , , 111 r r . . IIIII1 . , I . , , , , T J I , , , , , r r , , , , , ,
<br />D BUILDING 1$ ~/) /- <".t"'I I V
<br />. .;I r.p"-'v ALUATION OF TOTAL CONSTRUCTION
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<br />D ELECTRICAL 1$ -3'1 t./ 0 I AMP SERVICE ~ PROGRESS ENERGY
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<br />D PLUMBING 1$ q 3.:15 I
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<br />D MECHANICAL 1$ ~;l.~S- I
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<br />o GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I q 0,1 S- I
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<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
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<br />ROil!> I 'Z#",,yJl~IIIU4 ~ ,&t..73S'1lO I LOT# I /q~
<br />
<br />PARCELID#I t!J3 ...-<(p... 2/- O~3() - t:Joooo- /910
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />JOB ADDRESS
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<br />#IIIJ/E
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<br />SUBDIVISION
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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
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />DYES
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<br />DNO
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<br />PLUMBER
<br />SIGNATURE
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<br />
<br />Address
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<br />;=r: ~"':AI::"'RR":M~~ I
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<br />LIcense # I CBe 1~~S7S I
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<br />..I ~C cL ECTrc/ c:....
<br />I(y';) N I FEE CURRENT '!VN I
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<br />7?1 ,.,~t4 ~L LIcense # It:. C I :3 00/ f3 [3 "
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<br />SG-lIl ~ /VI/frJ ~v,.n /8/N?
<br />FEE CURRENT I N
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<br />-t"JlIn.tIUI rt LIcense # I epG 0'1/72 I
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<br />13#~()lIItFr ,q"uMeIAl~/ M
<br />N FEE CURRENT
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<br />
<br />BUILDER
<br />SIGNATURE
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Address
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<br />
<br />Address
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<br />. OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />
<br />LIcense #
<br />
<br />MECHANICAL
<br />SIGNATURE
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<br />
<br />Address
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<br />Address 1./2./1 S'I/MLwF8J.1lt') S'I*-IN~I/;u.. rL 31/~O? License # ICC-COS"?99/ I
<br />
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 t 1II11II1111111I111II111I11111I1111 t 111111111111 t I11I1 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 onsile, Construction Plans. Stormwater Plans w/ 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 (10) working days after submittal date. Required onslte. Construction Plans. Stor;mwater Plans wI Slit Fence installed,
<br />Sanitary Facilities & 1 dUlT!pster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />.."PROPERTY SURVEY required for all NEW construction.
<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 . J 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 NotJce of Commencement Is required. (AlC upgrades over $5000)
<br />
<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sew.W$..~..c.." ~ervlce Upgrades . AlC
<br />
<br />Driveways-Not ov~r'~~pWe:'lf o~'~~rtc,"rb~~~;;~:h;~SROW
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