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<br />Date Received
<br />
<br />
<br />:3 ~I ';2-0E>
<br />(4otJAlb
<br />535'1-- q~
<br />
<br />City of Zephyrhills Permit Application
<br />Building Departmj'\ 100
<br />
<br />
<br />Phone Contact for PermiUin
<br />
<br />Fax-813-780-0021
<br />
<br />813-780-0020
<br />
<br />.~ lOP'ELLE.
<br />33Sy..~
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />ST,
<br />
<br />s~
<br />S ('.( .l"H Cj
<br />
<br />Sel fll C
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />Sa H) E...
<br />
<br />JOB ADDRESS
<br />
<br />53Slf
<br />
<br />C1 t:b S'r,
<br />
<br />LOT #
<br />
<br />~
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I C A ~ Po R I
<br />
<br />BUILDING SIZE I (;l 'I' "- J &, ( SQ FOOTAGE I 3 g'it HEIGHT I 9/
<br />111111111111"'111111111111'1'1111111111111111111111"lllllllll'IIIIIIIIIIIIIIIIIIIIIIIIIIIII"111111111111111"'111111""1111111111""'1111111'
<br />I$~ 1.:2 g .:10
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />~ GAS I I
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />E3
<br />D
<br />D
<br />
<br />PARCELlD#1 iJ ,;1" )./ DOl () /3 b Db 0 1/ tJ
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I A LIA...f11 I,V it ;1)
<br />
<br />ROOFING
<br />
<br />I
<br />I
<br />I
<br />I
<br />G
<br />I
<br />
<br />AMP SERVICE
<br />
<br />I I
<br />
<br />PROGRESS ENERGY
<br />
<br />B
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D
<br />D
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />D
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY EJ
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />~NO
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />
<br />Address I I License # I I
<br />111I111111111111111111111111111111111111111111111111111111111111I111111111I111111II1111III111111111111I1111111111111111111111111111111111111111111
<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 wI 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 />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 />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 />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ti~~~': ' , , , , , , , , , , , , , , , , , , , . , , , , , , , , , , . . , , , , , , , , , , . . , , , . , , . , . , , , . . , . , , , , . , , . , , , . , . . . , , , . . '. ' , , , . , , , . , , , , , , . , . , , , . . , , . , , , , , , , , , , , , , , , . , . , , . , , , , .
<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.Attomey (for the owner) would be someone with notarized letter from owner ~uthorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A1C Fences (PloVSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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