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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 />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />':-': ." 't);:'~,I'W'.:..,>_ ,'\, Y,,:i',:i;~~:,lc.
<br />/,i OWner Phone 'Nurrib~r' .
<br />
<br />"1", ',.
<br />
<br />-';'..,/I{ Owner p~~ne Number I "..,~" '"
<br />OWner Phone Number I
<br />
<br />Fee Simple Titleholder Address
<br />
<br />HEIGHT I ~ ..Jro~J I
<br />
<br />0"'" ~~,~~;~~ . · , , , , " ',;" ..;;~. ~.;~' , , , , , , , , i ' , , · · ~~~~~;~~ '~~ ~~~;~ :~~';;.~;,~~' , ,,"," ... , , . . . .. ... .. . . . . . . . . , . . . . , , , , ,
<br />o ELECTRICAL 1$ J t.j t./ 0 I AMP SERVICE ~ PROGRESS ENERGY D W.R,E.C,
<br />o PLUMBING 1$ '-13:15 I
<br />o MECHANICAL 1$ if ~ ~S- I
<br />D GAS D ROOFING D
<br />
<br />
<br />N6-, fI-4C:::
<br />N
<br />
<br />License #1. ~ ACO Sg 0" 2-
<br />
<br />OTHER COMPANY C. .sr~et..IN," ~lJl/&..t'~ ,~QQ F'11J6-,J ZNC,.
<br />SIGNATURE REGISTERED I N FEE CURRENT N
<br />
<br />Address '12.11 ..sIlML " 'JoIIO S'I*-IN~ lit" ,q. 3I/HJ'l License # I ce..c O'S?99/ I
<br />, 111111111111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIUI,IIIlIIIJU:1:111111111111 i i I1I1I1111 i II
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new constructl()n,
<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 subdlvlslonsllarge projects
<br />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 wI Silt Fence Installed,
<br />Sanitary Facilities & 1 dumpster, Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />JOB ADDRESS
<br />
<br />I
<br />f.o~21
<br />lEI t.I9NO 1/4~k..
<br />
<br />I
<br />.8
<br />D
<br />D
<br />
<br />glllJ /E
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />~
<br />D
<br />181
<br />I A'.fW
<br />
<br />CoA.lS'1"ItAIc:n ON
<br />SQ FOOTAGE I
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW'CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />90 I /~
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SiGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address'
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Address
<br />
<br />COMMERCIAL.
<br />
<br />SIGN PERMIT
<br />
<br />BL..'D& 20 "_ \ \'
<br />
<br />ROil/) I Z~,!I~Y~J/Iu.J ~ ,&(, 33 SllO I LOT# 1200
<br />
<br />PARCEL ID#IO:3-:l{, -'d-J- 19.:1.30- 00000 - ZO 00
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />AD DIAL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />r
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />- -rOwl\l#omES
<br />
<br />'137\
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />LE/\/A./;f1C l-IoN'/E.s
<br />IrV N I FEE CURRENT 1<1 bN I
<br />
<br />License # I CBC/~~S7S I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />J8c' cI..ECTrelc-
<br />QYN
<br />
<br />L1cens.e #
<br />
<br />1[p1N I
<br />IE.C/300/BS'='
<br />
<br />fEECiJRRENT
<br />
<br />
<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 I I I . I . . I I ~ . I . . . . . . I . I . I . I I . ... I I I .OJ' I ,..,..~~, I ,t- ,...,. I -,1-,' I -I- I I I I. 1.1 I I I..' I . . . . I
<br />
<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 />.. Agent (for the contractor)or Power of Attorney (for the owner) would be someone with notarized letter from owner au,thorlzlngs~me'
<br />
<br />'OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs.S". L...._W.~~~~~~~,~~...<,OAlC
<br />
<br />DrIVeWays.NO~ ~y~~~W~~it oo/PGbn~M~~y~:i;~stROW
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<br />
<br />Fences (Plot/Survey/Footage)
<br />
<br />!:'-;'~"""~~"""""'~~~~."'''''~t_h.;.Hiwr,.'~'~.(.
<br />.. . J M .'3....,'.J~ifh:,
<br />m:n.;t;lt,m. seal ..:'Jf..'C(*~ i
<br />\'(1.3C)l~(;(Kj 'l; noiaaimmoO i? ~ ~~ ~
<br />80()~,a !)rmt.&~1Iqx3 ~!:s<''''#;
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