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<br />813-780-0020
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<br />City of Zephyrhills Permit Application r II 5' Q2)
<br />Building Department tp"'t I
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<br />Date Received
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<br />Owner's Name
<br />
<br />Owner's Address
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<br />Fee Simple Titleholder Namel ~ uQ
<br />
<br />ftS;"vP
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />I
<br />I
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<br />7'o..j~o 0/'9/A dfl vcY.
<br />'7050 6AL.~ IJlrl&,
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
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<br />BLOCK
<br />
<br />I
<br />B
<br />o
<br />o
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<br />LOT #
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<br />PARCEL ID#l55~02.J-02/-0{)/D - Jt).!J~tJO -(]ODCJ
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />SUBDIVISION
<br />
<br />~
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
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<br />DESCRIPTION OF WORK 1d5 f' I I.. l",v ~.AQ (/::;,u+ /)(7' ~ o,,[J(!/? ($.Id C 1,/-h tua/Jt
<br />
<br />BUILDING SIZE I ' I SQ FOOTAGE I I HEIGHT I . I
<br />
<br />.'.111...'"....1111.11...11....11...11......11......11..1111..111...........11......'.....,.....,.....;.1111..........11111......1111111111........,
<br />
<br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION o?- j(~~"::'O
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<br />D ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
<br />
<br />
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING 0
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<br />FINISHED FLOOR ELEVATIONS I I
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
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<br />OTHER lL7o~Yf' R~ in ,-C),'d2A. ,1haLI<
<br />STEEL D OTHER I L!(Ji,xyu..flL
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
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<br />DNO
<br />
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<br />
<br />:::;~~~~RE L1L:t(~,
<br />
<br />Address ~305 L!t4fflb~ 19t1tz.....
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<br />I SftAi4~F {!avll2t4~/;"R ,,<)4il.V,'US ~.1
<br />I Y IN, FEE CURRENT I Y I N I
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<br />License # I~ IJ-; tf(;'9& I
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<br />I
<br />I
<br />I
<br />I
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<br />I
<br />I
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<br />I YI N
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<br />FEE CURRENT
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<br />COMPANY
<br />REGISTERED
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
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<br />License #
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />YI N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y I N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
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<br />111II1111111111 111111111111111111I1111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111I11111111111111111111111
<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 wi 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 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 />IIIIIIIIIIIII.IIIIIII.III/IIIII!III..IIIII.IIIIIIIII.I1,111111/11"/11,1"1/1.,1,11.1",111,1,,./11,1,1,,1,.1IIIIIIIIIIII/IIIIIIIi'II'II!11111/111
<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 AlC Fences (Plot/Survey/Footage)
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<br />License #
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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