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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 />Date Received
<br />
<br />
<br />
<br />Owner's Name t. N ^'
<br />Owner'sAddress I "00 AI. td4srsNoIZE ~J..t/O" ~(jD -t:flff"Ii/
<br />Fee Slmpl'e Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />(P3;l. 3
<br />
<br />I E"..I9NO /1t11..k..
<br />
<br />RL"'D (::;; '2.6
<br />
<br />D
<br />D
<br />D
<br />D
<br />
<br />~
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION IKI
<br />
<br />DESCRIPTION OF WORK I ,A/~w CoIf/S'1';evc:n ON - 'OwN lIoA?ES
<br />
<br />BUILDING SIZE SQ FOOTAGE I '/53 \ I HEIGHT I R J'?'DI'l,!f I
<br />
<br />0' " , I ~~I~~;~~ ' , , , , . , . 'i~ I , I;; ~ I ~I; ~' , , I , IIII i '" , , ~~~~~~;~~ '~~' ~~~~~ '~~~~~~~~;I~~IIIIII , , . . . 11III111 , I . I , , , I , I , 111I1II11I11
<br />1$ :it/t!O I
<br />1$ '13::(5 I
<br />1$ ~;J. ~S- I
<br />
<br />D ROOFING D
<br />
<br />NEWCONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />RDl9b, 'Z~;1/1Y~IIIt.U ..'&t."3S~ I LOT# 1/98
<br />
<br />PARCEL ID#I t).3 - ~, ...;; / - tJ-? 3{) - &()OOO -/990
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />.MI?IJ/E
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />~
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />C/O,/5
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />GAS
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />t:=J YES
<br />
<br />DNO
<br />
<br />Address
<br />
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />LENA.//I~ J.!DME.s
<br />I~N I FEE CURRENT I~ I
<br />
<br />License # I CBC.I:(1S'S7S I
<br />
<br />\J?c €L€CT~/c:....
<br />'--Cl)N I FEE CURRENT V~ I
<br />
<br />License # It:. C I :3 0 0 / e s "
<br />
<br />.fGil'GMIf,J AVhr IUN?
<br />FEE CURRENT N
<br />
<br />License # I C;::,C 01.//'72 I
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />Address
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />. OTHER COMPANY AU" ~ rNC. .
<br />SIGNATURE REGISTERED Y N
<br />
<br />Address '1'2./1 -Sf/OIl FBJ.I/o S',*,IN6-IItU. r:L 3tjH)~ License # ICC-COS"?99/ I
<br />
<br />1I111111II111111I11111I11I111I111111111111111111111I11111111111I111I111111111111111111111I11111111111111II11lilllllllllllllllllllllllllllilllllill
<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 w/ Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvislons/large projects
<br />COMMERCIAL. Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new constructlpn.
<br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Stormwater Plans wI 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 />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />DI~~~ti~~~': ' . . . . . . . . , , . , , , . , . . . . . . . . . , . , , . , . . , . . . . . . . , . . . . , . . . , , , , , , . , . . , , , . , . . . . . , , . , , , . . . , . '. . , . . , . . , . , . . . . . . , . , . . , . . . . . , , , , . , , . , , , . , , , , , , , , , , , , .
<br />
<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 $5000)
<br />.. Agent (for the contractor) or Power of Attorney (for the owner) would be someone wtth notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs SElw.W:l.......,...." .~!!~Ice Upgrades AlC
<br />~.......1'...,.,._'"'...,..'...'..,',<.."r'..'''',~'Ii'''.."..
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<br />Driveways-Not ov~i~i>$~t~;'I.f otfJlIJbili::'rb~w;!yfh'~s 'ROW
<br />; '" (~"~::'("::i"':::': '(hi~~}.: ~
<br />
<br />Fences (Plot/Survey/Footage)
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