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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 />Fee Simple Titleholder Address I
<br />
<br />h3/9
<br />
<br />
<br />Owner's Name t. EN,
<br />Owner'sAddress I '00 AI. WEsrs#o1ZE ~J..1/()7tI ?(jD ~tI1/"
<br />Fee SImple Titleholder Namel
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />BL-:i:>(;,; 2.0 ".
<br />
<br />ROil!:> I Z~I',t/jI.t!IIIu.J" ,&(...73$'110 I LOT# 1/99
<br />
<br />PARCELlD#1 0 3~ 2'-.:/1- ():230- 00000- /990
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />JOB ADDRESS
<br />
<br />g"'IJ/E
<br />
<br />SUBDIVISION
<br />
<br />lEI t.I9AJo /1f,,-"-
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />~
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION IS!
<br />
<br />DESCRIPTION OF WORK I NEw CoIV.s-r~cn DN -rOWN.IIo/I?ES
<br />
<br />BUILDING SIZE SQ FOOTAGE I I 3 7 , I HEIGHT I ;l .J""'o~.Y I
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<br />D"'" ~~,~~;~~"""'" i;" ..;;~' ~;~""'..., i"'" ~~:~~~;~~ '~~ ~~~~ '~~~~~;,~~"""""""'" """""""""""'"
<br />D ELECTRICAL 1$ .3 t/ t./ 0 I AMP SERVICE ~ PROGRESS ENERGY D W.R.E.C,
<br />D PLUMBING 1$ t..f 3.;(5 I
<br />D MECHANICAL 1$ '/;1. ~S- I
<br />D GAS D ROOFING 0
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />qo,/~
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />Address
<br />
<br />
<br />
<br />LE/IIA./~~
<br />I[9N I
<br />
<br />FEE CURRENT
<br />
<br />lIoME-S.
<br />dYN I
<br />I C8C./.'<S-S7S I
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />
<br />
<br />../Bc cl..ECTrclC-
<br />N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />MECHANICAL N6-" 9' '" c:.
<br />SIGNATURE 1 N
<br />
<br />Address License # I CAe Osg O(pZ
<br />
<br />. OTHER COMPANY C,S ~1?t.IN(, ~vllL.t" R.oo ~ utr~ :l"NC..
<br />SIGNATURE REGISTERED / N FEE CURRENT N
<br />
<br />Address LI'l11 SliM/.. LIN 'J.IIC) Sl*-IN611tu rt. 3YHJ'l License # I CC-C 0$'?99 / I
<br />
<br />III I I I 1I11111111 I II I 11111111 I 11111 I II I I III I I 111I11 I I I I 111I1II1 I 11111111111111111111 I 11111I11111I1I111111I111111 I 111111111111II111I11I111I i I11I1 ill
<br />RESIDENTIAL. Altach (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 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, Stormwater Plans w/ Silt Fence Installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requli'ements must meet compliance
<br />SIGN PERMIT' Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<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 $5000)
<br />
<br />.. Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs SeWD...... ' . ' . Service Upgrades AlC
<br />"'!li.",-...~, '~'~\,''''''''''"''l',:,,,., .,;.'~....-.. ~....:,;. .",p"4'~~,,"-'
<br />
<br />Driveways-Not ov~~~a$K(e;'lt of{paliil6'rb~dwa-Y~~:h'&lldsROW
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<br />.."..',,::,:; ...;;":i.::: .: > '-,: ."~ r4:.~'; ....
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<br />Fences (Plot/Survey/Footage)
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