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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />
<br />ePf'V
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner's Name Ol. V' l. VI. Y\L
<br />Owner's Address I ~ ~3C }J /) .~ -t1A It'\.- 4 D V
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<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />I ~r 3S- ;U // r -tt-. ! ~lu.-
<br />I
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<br />~l1h '1Yt-,., "I IJ fl 3~YL I LOT #
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<br />PARCEL ID#lo~ --2(; -'2.-1 -01 L(J -00000 - CJrOu
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />D
<br />D
<br />D
<br />D
<br />D
<br />
<br />Or
<br />I
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<br />E3 NEW CONSTR c::::J ADD/AL T D
<br />INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME D STEEL 0
<br />
<br />DESCRIPTION OF WORK II2-L'fU of- wi ot '30 r Ct.. v G"' A F 77 M ~r It ~(
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<br />I SQ FOOTAGE I I/O 51 HEIGHT I
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<br />II 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 'J 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 I . I . I I I I I I
<br />
<br />1$ ?tfCjO~Ob
<br />1$
<br />1$
<br />1$
<br />GAS ~
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<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />ROOFING
<br />
<br />D
<br />I
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
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<br />, I I . . I I I I , I pi' I , f I I . I r I . . . . , , W I r I . . . I 1 , I I I . t I . r , t , t , I I , , , I I . I . . f , I I I I . 1 , 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 r I I ~ I . , , , I . . . . I I I I I I I I I I
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<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 />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I COMPANY
<br />SIGNATURE . REGISTERED
<br />
<br />Address I
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<br />~,'ci'N"'tURE l~ ~ ~~:~":';:,
<br />
<br />Address 133DlO S. (l ~. Z- PC ()OX l WJ~", tmro(-l3 "3!:>-7(, I
<br />
<br />Y/N
<br />
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<br />II11I111111I1111111111111111111I1111I11111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 subdivisionsllarge 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 />1111111111111'11111111111111'111111111'111111"111111111'111111111'111111111111111111111111111111111111111111111111111111111111111'11111'111111111
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A1C
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<br />License # ICC(O,C77~-7
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<br />Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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<br />,j $~;'/(i"J' "',~ ~
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