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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 />1
<br />Date Received II ~ 07
<br />
<br />Owner's Name Ar+"t' PA + Be:s i/t e.('
<br />Owner's ~ddress 138'f3S +3~1I3' s-tt' Allen'"
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />13<gLi35~ S.11
<br />I
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />AII~(lue
<br />I PARCELlD#1
<br />~
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />E3
<br />D
<br />D
<br />I Build
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />flew
<br />
<br />Storefron+
<br />SQ FOOTAGE I
<br />
<br />fQ~~&e
<br />
<br />HEIGHT I
<br />
<br />BUILDING SIZE
<br />
<br />11II1 II , 1111111 . II I 1II111I1I1 1 III . III . 11111111 . III , I II . n I 11'1 I , n I , I . III , 11111 " I II n I , , III III1 II . III P II , . II .. I" IIII , , t 1 . IIIIII . I " I III . IIIII .
<br />
<br />OS]
<br />
<br />1$ 58, 1.P5 o. ~
<br />
<br />D ELECTRICAL 1$ N/A
<br />
<br />~g~ NOe ~
<br />D PLUMBING 1$ "'IA ~L~~n GeM\ jR'"'. _ ~e;:S,
<br />
<br />D MECHANICAL 1$ NVII VALUATION OF MECH~ICAL INSTALLATION [) . \.' D~~{t'<,6
<br />. _ ,., t"LN &- ~f ..11"1/"7
<br />D GAS D ROOFING D SPECIALTY D OTHER ~/rn - \\hctl~~ _H~~
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DY~~ ~ ~~o " ~~~;:-V
<br />
<br />11II111111111111111111111111111I11111111111111111111I1111111111; 11I1111II111111111111111111111111111111111 ill i i1111~tililll 'fi.ll f1'11'1 n I i (Ii 11'11111 '
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />BUILDING
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />WREC,
<br />
<br />tJL;/.kJW I
<br />It/lit E. GQry Rd. ~I<el"'(lol, FI 33'0 ,
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />
<br />License # I I
<br />
<br />
<br />~:;'H::TURE 5;.:: ~~_~ ;:'o'::::'~ I~~ F~~ ~hJk
<br />Addres~,O~~'1~ ~IyJ.l~~:~ ~~D~ I License # I ' I'
<br />
<br />1111I1111111111111 ~ 1111 i 1111111111 i 111111111111111111111'11 i 11111111111111111111111111111I111111111111111111111111I11111I1111111111111111111111111
<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 />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 />Attach (2) sets of Engineered Plans.
<br />.._.PROPERTY SURVEY required for all NEW construction,
<br />
<br />Address
<br />
<br />License #
<br />
<br />I c.6C O~I ~5
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />D,~~~ti~~~': . , , , , . . , , , . . , , , . , . . . , , , . , , , , . , , . , , , . . , , , . . , , , . . , , , . , , . , . . . , , . . , , , . . . . , , , . . . , . , . , , . , . . , , , . . . , . , , , , , , . . . , . 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. (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 roadwaysuneeds ROW
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