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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-78D-0021
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<br />Date Received 7-- -:2 - D 8
<br />
<br />..111..1111
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<br />Owner's Name L ~ t) ~\..l- \L",-\<o\.\\ --b eh yi S
<br />Owner's Address 14~\ 9cW\.I~~ .fi..t..€-~~~\\lP\ 2'23.\\
<br />Fee Simple Titleholder Namel S;"'M.CC:.
<br />
<br />
<br />Fee Simple Titleholder Address I ~~.
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />D
<br />
<br />D
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<br />D
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<br />
<br />~~3e ,,^-8HtAl... \htW ~ , Z€:Q\\,\~\\...k~ LOT #
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<br />""'J){L\>c:...Jrt.. I PARCELlD#I02.-2b-2\-O~-OCOCO- ~...,C
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />El NEWCONSTR ~ ADr@) 0 SIGN D MOVE 0
<br />INSTALL D REPAIR
<br />PROPOSED USE D SFR ~ COMM 0 OTHER
<br />TYPE OF CONSTRUCTION ~ BLOCK D FRAME 0 STEEL D
<br />
<br />DESCRIPTION OF WORK I I~\t~~ c~'-\ ~"'~"'~-n~~ ~tL ~W ~""~~"T
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<br />BUILDING SIZE l.so "')(. 4.5 I SQ FOOTAGE I '"2 \ '2 SO · 0 I HEIGHT I \0' W~C:;
<br />TI,'P11111111IIIII"Ir,IIIIIIIIII,II..'IIIIIIIIIIII,t,"'1111111""1111111111111111111111111111111111111111111"1'111"11111"11111111111"1111"
<br />1$
<br />1$
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<br />1$
<br />D
<br />
<br />JOB ADDRESS
<br />
<br />7
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />AMP SERVICE
<br />€..~\\~b
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<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION ~ ,OS:1:::C).cJ:)
<br />
<br />ELECTRICAL
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<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION 4 9,CXXJ .OC>
<br />
<br />GAS
<br />
<br />ROOFING
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />o
<br />
<br />OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I E..')(.l~~\I'{~
<br />
<br />DYES
<br />
<br />~NO
<br />
<br />Address
<br />
<br />
<br />
<br />FEE CURRENT
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />License # I ~ \ "2.S~ \ 4-
<br />
<br />M~P\~ t,~\lU.'-.
<br />I Y / N I
<br />
<br />I Y/N I
<br />License # I E.t..- \ 3<:;)C) \ '6 ~ ~
<br />NC)~
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />"03524>
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />}-...\~~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License # I ~J A.
<br />
<br />MECHANICAL I ~\-\~ ~~\>~ ~ t. ~) c...
<br />SIGNATURE I Y / N I FEE CURRENT I Y / N I
<br />
<br />Address 444\ ~ License # 1C.f\C-OI.\-D~B
<br />
<br />SOITGHNEARTURE NCl>>E COMPANY No~~ I
<br />REGISTERED Y / N FEE CURRENT . Y / N
<br />
<br />Address Nj ~ License # N) Ii..
<br />11111111I11111I1111II111I111111111111111I111111I11111111111111I11I111111I111111111111111111111111I111I111111111111111111111111I1111111111111I11111
<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 w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/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 onsite, Construction Plans, Stormwater Plans w/ Silt 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 />
<br />Di~~~t;~~~': . , , . . , , , , , , , , , . , , , . , . , , , . , , , , , . . . , , , , . . . , , . . . . , . , . , , , , . . , , , , . , , I , , , . . , , , , . , , , . . . , . , , , . . . , , , , , . , , . . . . , . , . , , , , , , . , . , , , , , , , , . . , , , , . . . , , . . .
<br />
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (A1C upgrades over $5000)
<br />
<br />Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs r~~' ,servig.e~dEL.."ll'..... C
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<br />Driveways-Not dyer Gotl",ter if on public 'fQadwaYl{:~Eid$:.R
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