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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 />'''/ (p ~13-780-0021
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<br />Date Received
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<br />Owner's Name
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<br />Owner's Address 3t" ~ I
<br />Fee Simple Titleholder Namel
<br />
<br />..-:--.
<br />) A.r(
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<br />~r. 2-1h/I~ 335'10 I
<br />I
<br />
<br />I
<br />I
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<br />I
<br />2 -J:f,I/ J335'~6 LOTti I L// I
<br />PARCEL 10#/ 35- 2-5- 2{ -.06 (0 - UScYo~ DbOD I
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
<br />SIGN D MOVE D
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address 1
<br />
<br />I "S,t''' 5'/ In rr ))".
<br />I (ti,,~ ()t/<-5f<f art!} 1
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<br />SUBDIVISION .
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />/
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />B
<br />D-
<br />o
<br />S" ew-e~ tJ ~ !J;;:rfh { I
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<br />BUILDING SIZE I .' I SQ FOOTAGE / . I HEIGHT I . . - I
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<br />. '. , . . . , . . . . r . . r . . . . . . . I . . . . . . ~ . . . . . . . . . , ' . , I . . . . . . . , . . . . . . . . . . . ; , . , . . . . , . , . . . . . . . . , . . . . . , . , . . . . . . . . . ,: . . . . . . . . . . . . . . . . . . , . . . . . . . . . . , . . . . I ' . , . . . , , . I
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<br />o BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
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<br />o ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
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<br />o PLUMBING 1$ I
<br />o MECHANICAL 1$ / VALUATION OF MECHANICAL INSTALLATION
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<br />o GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />, , I ' , 1111 . . III , . , I " r . , . II r . I . , r . '\ ':., 1/ . , . , . . , . , I . II . '11 r II . . r I , , . , " , , '1111/ . . , . , I . I r I . . II' . I . , I . . I ' . I' .. . . . . . r . . , I . . , . . , . . r . , I . . , I . . . I .. . , .. 'II
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<br />:~~~~RE I m~ Ja(/ I ~::.:.."': I y,qItJ~",OR'", Y/N I
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<br />Addres.s I License # I I
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<br />ELECT~IC.IAN I COMPANY 1
<br />SIGNATURE _ REGISTERED -, Y / N FEE CURRENT Y / N
<br />
<br />Address I License # I
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<br />
<br />:::::r'i.':.e I ~~=~ Y I N ",""OR"" Y I N I
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<br />
<br />Address / License # I
<br />
<br />MECHANICAL I.. COMPANY I
<br />SIGNATURE _ REGISTERED Y / N FEE CURRENT Y / N
<br />
<br />Address I License # I
<br />
<br />OTHER ( COMPANY I
<br />SIGNATURE _ REGISTERED Y / N FEE CURRENT Y / N
<br />
<br />Address I I ' License # I
<br />11111111111 , 11111111111111111111 , 11111111111111111111111.1111111111 111,.111111 111/1111111111,1,1111.,,1,,111111,,1111111 " 1111111111111111 111111111
<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 onslte, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facililles & 1 dumpster; Site Work Permit for subdivislonsllarge projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safely Page; (1) set of Energy Forms. R-O-W Permit for neW construcllon.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence Installed,
<br />Sanitary FacUlties & 1 dumpster. Site Work Permit for ail new projects. Ail commercial requirements must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.'
<br />....PROPERTY SURVEY required for all NEW construction.
<br />1/11111111111111111111111111111111111111111111.1111111I111111I1I1I1I1I111111111111111111111111111II11111111111111111111111 i 11//111 , I i j j Ii I1I1 j J 111I
<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 cqntraclor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />JVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plol/Survey/Footage)
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I
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<br />I
<br />I
<br />1
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<br />DESCRIPTION OF WORK
<br />
<br />D
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<br />W.R.E.C.
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<br />Driveways-Not over Counter If on public roadways..needs ROW
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