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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />-7 ~ /5
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Nuniber I
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<br />Owner's Name (,,",\I" G ~!..V'
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<br />Owner'sAddress I 342./ L, II+~ f1v<
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<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />1312-1 Co {/ f-t-t
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<br />IJ-v<.
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<br />?-h,'1fJ
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<br />"33S-Y7-.
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<br />LOTti
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<br />D NEW CONSTR El ADD/ALT D
<br />D INSTALL REPAIR
<br />PROPOSED USE D SFR D - COMM D OTHER I ' I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I I
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<br />DESCRIPTION OF WORK I R--e vb v ..(.- v:J/ (JA 3 0 '7f- 'l " G Ii- r: 7J ~ U v 7 I ~ I
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<br />o BUILDING 1$) z-,c:n) . c) a I VALUATION OF TOTAL CONSTRUCTION
<br />o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ 1 VALUATION OF MECHANICAL INSTALLATION
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<br />o GAS ~ ROOFING D SPECIALTY D OTHER ,
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />PARCEL 10#1
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<br />SUBDIVISION '
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<br />/1--2- r.,-2{- b,2-(Pc) -02..0(,'0 -~ I LDO
<br />(OBTAINED FROM PROPERTY TAX NOTICEI
<br />SIGN 0 MOVE 0
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />W.R.E.C,
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<br />COMPANY
<br />~EGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED I Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License # ' I
<br />COMPANY qwfl-j] k <-k ~V\. foo,t; j1 ..
<br />REGISTERED 'YI N I FEE CURRENT I Y/N
<br />...........! License # CCC 0
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<br />BUILDER
<br />SIGNATURE
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<br />Addres,s
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE ,
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<br />Address I '
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<br />~~::tURE I ~ ' w---
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<br />Address 13) Q ~ 0 .syL S- L t D 6 b^ I U%"
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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 subdivlslonsnarge projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (1) sel 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />1111111111111111111111111111111111111 I 11111111111111111111111111111111111111111111111 111111 11111111 III 1111111111111111111 i 111III I II i i II i III1 i 11111
<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)
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<br />.. Agent (for the cQntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner auihorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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