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<br />Date Received
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />813-780-0020
<br />
<br />15/~'3
<br />Owner's Address
<br />Fee Simple Titleholder Namel
<br />
<br />:() r.
<br />
<br />ex.
<br />tY:(~ MUU1"'i. Fl- I
<br />. ~ 3."5;:; -3. 6'.f '/l'i
<br />
<br />I
<br />
<br />Owner Phone Number 81?> 88.5 7;
<br />Owner Phone Number I (rl ~f g 6, /7 '-f f
<br />Owner Phone Number r ~ ( ~ Ill!) , r; '7 '11
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />r;jt;!f!!fi!f&}!-J"'!j/'~P I LO" 113/3
<br />IJ. -----:- .~. PARCELlDOlm-&lo-<9I-rrw-rD?:1:O-0130
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />M NEW CONSTR 0 ADD/All 0 SIGN D MOVE D
<br />IZ::::] INSTALL D REPAIR
<br />PROPOSED USE [:EI SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I Lrbqj (l) j '4at:Li:uL
<br />
<br />I SQ FOOTAGE I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />~
<br />
<br />OTHER I I {( '(b (...., r'\ T /01\)
<br />
<br />BUILDING SIZE
<br />
<br />I
<br />HEIGHT
<br />
<br />. I I . . . . I . . . . I . . . I I . . . I I I . I I I . I r , . . . 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 . . , . II . I I I I I I I I , I I I I I . I I I I I I
<br />
<br />0 BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
<br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C.
<br />[2g PLUMBING 1$ qW.'-- I
<br />0 MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />0 GAS 0 ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />, , , I I I I , . . r , . I I . . I , I , I I I I I I I I . I , , , , I I I . . . I , I I I I . , , t I . I I I . I , , , I I 1 I , . . I I . , , I r 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 r I , , , I I
<br />
<br />BUILDER
<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 />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />YIN
<br />
<br />Address
<br />
<br />~ <- -.. ~::.~::::
<br />Addre "1/1r;o~t:) f(&f5PffLl ~f-I, fL (~J(.PIO
<br />
<br />MECHANICAL COMPANY
<br />SIGNATURE . REGISTERED
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N(fj
<br />
<br />'-'"---
<br />
<br />I ~/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />I111111111111111111111111111111111111111111111111111111II11111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111
<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 subdivislons/large projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page: (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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />11111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111I1111111111111111
<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 />
<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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