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<br />812,-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 />11...11...11
<br />
<br />Owner's Name J e:r.ue. (. -
<br />
<br />
<br />Owner's Address 1.35U~ ~ALAC.~ln: Di2. ZeP/'bIIe.H 1'-'-5, F~
<br />
<br />
<br />Fee Simple Titleholder Namel I
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
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<br />1.35/10 H ALACN- Ire De..., 7 F PH VLHILLS. FL ;3 3~~
<br />I El-fE./ZALD ~/Nr~ RV RvzJ
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<br />JOB ADDRESS
<br />
<br />LOT #
<br />
<br />I~I
<br />
<br />SUBDIVISION
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<br />PARCEL ID# I .)..'/ -ol4 -rL/ - 0 r) V d - aJOeJd - / J/ a
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />WORK PROPOSED
<br />
<br />~
<br />D
<br />D
<br />
<br />B
<br />D
<br />[Xl
<br />(51-ora J atAtiL
<br />
<br />SQ FOOTAGE I .3 8 tf
<br />
<br />NEW CONSTR
<br />INSTALL
<br />
<br />ADD/ALT
<br />REPAIR
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />SFR
<br />BLOCK
<br />
<br />COMM
<br />FRAME
<br />
<br />DESCRIPTION OF WORK
<br />
<br />I-a ntLC:
<br />
<br />BUILDING SIZE
<br />
<br />\3 ~ X I;)...
<br />
<br />1$ I
<br />, /tJ,()l)O.
<br />
<br />1$ 1,{)O8, I
<br />
<br />I$~I #0 /JIlt- I
<br />
<br />D MECHANICAL 1$ ,J fA I
<br />
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I.L" I
<br />'r (J.,,'EIZ. e.XIS/lNG S~
<br />
<br />BUILDING
<br />
<br />D
<br />
<br />IRJ OTHER I SID t?-Ft-GF.
<br />D STEEL D OTHER I
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<br />Sc,ee.v-- roo""" / c::<t-d eonc.r~fe-
<br />
<br />HEIGHT I I tJ I (;, Ii
<br />
<br />DEMOLISH
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />~ PLUMBING
<br />
<br />D
<br />
<br />IKI
<br />
<br />W.R.E.C,
<br />
<br />PASCO PERMIT SERVICE
<br />(813) 788-5314
<br />VALUATION OF MECHANICAL INSTALLATION FAX 1-866-824-7894
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />
<br />Address
<br />
<br />
<br />MECHANICAL It/a.-
<br />SIGNATURE, !(
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />
<br />111I1111I11111111111I1111111111111111111111111I111II1111I111II111111111111111111111I11111I11111111111111111111111111111111111I111111111I1111111111
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<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 onsite, Construction Plans, Stormwater Plans wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsite, 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 />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />5{]NO
<br />
<br />
<br />License #
<br />
<br />t)wner-
<br />I Y I N I FEE CURRENT
<br />
<br />I Y/N
<br />/1 / t:U
<br />
<br />License #
<br />
<br />Y I N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y / N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />DI~~~ii~~~':' 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 ,
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<br />Fill oul 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 Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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