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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 />Date Received
<br />
<br />
<br />
<br />Owner's Name c/ AI ::::t'r' <:.
<br />
<br />Owner'sAddress I 73ot./ GML f3L VI.)
<br />Fee Simple Titleholder Namel '37701 0111<.,e (.IAl C4. (./ C
<br />
<br />8'"/3 7/'-/ - 2 &> 57'
<br />~/3 7" - 275(
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />JOB ADDRESS
<br />
<br />3770 I
<br />I 01\ (( /2. VtJ
<br />
<br />Oftl'- (( l,)N Ctlc.le
<br />I PARCEL 10#13 t./
<br />
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />t3/
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK IIkI d' { , Pi!
<br />~
<br />
<br />&x /2 I
<br />
<br />WORK PROPOSED
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />€!
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />SQ FOOTAGE
<br />
<br />
<br />(
<br />7 '../4-'(
<br />
<br />BUILDING SIZE
<br />
<br />D BUILDING 1$
<br />
<br />D ELECTRICAL 1$
<br />. I,Oot>,.....
<br />D PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />D GAS D ROOFING
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />ZI.; 21 0000 00306 0(00
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE D DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />:~ ~C'..,..,l,.;v ~
<br />HEIGHT I 7' Lj ,.
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />WoR.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />
<br />PROGRESS ENERGY __-D.
<br />
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />I I I . . . I I I I I I , I . . . If' . I I I , . , . . I I I I II I I I . . , , . . I , I I I . , I . I . . I , I I I . . . . , , I III . , , f r II . , , , , , , I II r I . I , , , . , I I . f r II r I , ~ I I . I I , I I , . I I , I , I I I I , I I . . , I , . . . I , I 11 II I
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />111111II1111111111111111111111111111111111111111111I111I1I111I111111111111I11111111111111111111111111111I1II1111111111111I11111111111111111111I11I
<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 />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 w/ 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 NC Fences (PloVSurvey/Footage)
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />.,J-1.lZ ~C
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Driveways-Not over Counter if on public roadways"needs ROW
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
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