|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />
<br />Fax-813-780-0021
<br />
<br />11' 1#q
<br />
<br />Date Received , 3t)/~
<br />
<br />
<br />Owner's Name Q. c I , :" ~ .
<br />
<br />
<br />Owner's Address I . .s'f'1J d..
<br />
<br />
<br />Fee Simple Titleholder ~amel
<br />
<br />
<br />26ph yjt.h ,'11 &
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number [
<br />
<br />Owner Phone Number I
<br />
<br />Jqa>.cot. 2E.phlfl'hallS FI '35~'-' LOT'
<br />
<br />1 PARCELlDN[I/. AI, . d./~ Ot/lt'}. 077~(J. t'Jo? I
<br />(qaT A1NED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR D ADD/ALT 0 SIGN 0 MOVE 0
<br />D INSTALL D REPAIR
<br />PROPOSED USE 0 SFR 0 COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0
<br />
<br />DESCRIPTION OF WORK I ~'L. yo Ol'l':; .- Po I1$' L (~Prf/
<br />
<br />~UILDING SIZE I . I SQ FOOTAGE I I HEIGKT I I .
<br />
<br />I ~".""""""""""""""" "......;,...,.", ".."".. I.."..". "'.."....,..:..,......"...",."",..."", "."'...".."".,..,.'. ..I
<br />
<br />o BUILDING 1$ /1/ .. I VALUATION OF TOTAL CONSTRUCTION
<br />. 1.' pt')C ' <J"c
<br />o ELECTRICAL 1$ I
<br />
<br />o PLUMBING 1$ I
<br />o MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING 0
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />Fee Simple Titleholder Address 'I
<br />
<br />JOB ADDRESS .I..sS'(J""
<br />
<br />I
<br />
<br />SUBDIVISION
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />OTHER l
<br />
<br />I
<br />I
<br />I
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGV
<br />
<br />o
<br />
<br />W.R.E.C
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DVES
<br />
<br />DNO
<br />
<br /> LIcense #
<br />YI N FEE CURRENT
<br /> License #
<br />V/N FEE CURRENT
<br /> LIcense #
<br />V/N FEE CURRENT.
<br /> License #
<br />
<br />
<br />BUILDER
<br />SIGNATURE -'
<br />
<br />
<br />
<br />ELECTRICIAN
<br />SI~NA TURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />V/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />V/N
<br />
<br />. Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />V/N
<br />
<br />Address
<br />
<br />COMMERCIAL
<br />
<br />Address I License #
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIIIIIIIIII1IIIIIIIIIIIIIIIIIIIIIIIilllllllllllllllllllllllllllllIIIIIIIIIIIIIIIIIIIIIJIIIIIIIIIIIIIII
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
<br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />Attach (2) sets of Engineered Plans.
<br />""PROPERTY SURVEY required for all NEW construction.
<br />1\11 1111111111 111111111111111111111111111111111\11111111111111111 11111\111111111 11\1111 11111 111\\1111 11\ II III 11\\11111111 11111\11 , 11111111\1111111
<br />Directions: . . .
<br />Fill out application completely.
<br />Owner & Contractor sign back of application. notarized
<br />If oyer $2500, a Notice of Commencement Is required. (AlC upgrades over $5000)
<br />
<br />.., Agent (for the contractor) qf1'l!vaft~,,;. r 'f:"h&.QI,W~~~ would be someone with notariz
<br />
<br />OVER THE COUNTER PERMI~. ~~Appllcatlon OnM
<br />Reroofs Sewer~, :!"!oIjjll\'ll.llal.~ali.~ ' Alf Driveways
<br />· . . ' "(l,Uf(',,,,,:, . 1
<br />" v.......~ .J"" ~t1 -..tr
<br />
<br />---~......._~..........
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />SIGN PERMIT
<br />
<br />
<br />.9JiU ~f, l}\t!horizlllg S!in1l'I,;
<br />.,. j....;~. ,:. ->,--_.:w,""''''~'''-'~f,-.i''
<br />
<br />0' ~Pis ~StJrveY/~g
<br />, t\g~~ \'\ ~~nQ.:' - -;,~,_ ,r>,,,,,:,,'A
<br />~~Qf~ -
<br />
<br />
<br />L.::~';- ," _J~; '),':
<br />
|