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<br />813-780-0020
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<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />"'II"'."
<br />
<br />Owner's Name
<br />
<br />Owner Phone Number
<br />
<br />"P63rn~one Number I
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<br />Owner Phone Number I
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<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
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<br />WORK PROPOSED
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<br />1e.~J\s ~L~3e:;L\ \ I LOT# 13!5()
<br />PARCEL ID#~ ~C) -r') \ -6 ft0 -cYfY.'(') - ~ SC:f:')
<br />(OBT A'NED FROM PROPERTY TAX NOT'CE)
<br />D ADDIALT D SIGN D MOVE D
<br />D REPAIR
<br />D COMM D
<br />D FRAME D
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<br />SQ FOOTAGE I \ 3C\. L\ I
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />DEMOLISH
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<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER
<br />STEEL
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<br />OTHER 1fT10'ri1 k. ~~ _ I
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<br />DESCRIPTION OF WORK
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<br />BUILDING SIZE /91o't.5 ~
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<br />
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<br />1$ 5,cao, Ci'-l
<br />1$ loOO,OCJ
<br />1$ (cCO,(X)
<br />1$ r 5~, t'lD
<br />
<br />1
<br />c=J GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />HEIGHT
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<br />ROOFING
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.R.E,C.
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />c=J
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<br />ELECTRICAL
<br />
<br />PLUMBING
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<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />9DNO
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<br />
<br />COMPANY ~~
<br />REGISTERED I Y I :--
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<br />Address 13~&%'SV~ hl4-: fQJ 1:-~\'3 335Lld
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<br />Address I~~ Skh'af-L ~'8 55C)L\()1
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<br />BUILDER
<br />SIGNATURE
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<br />MECHANICAL
<br />SIGNATURE
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<br />FEE CURRENT
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<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />I Y IN I
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<br />License # I ES C:f"C'lM(o \
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<br />LU:.-
<br />FEE CURRENT I Y I N I
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<br />License # tt::t\ -Lt:ro/014
<br />
<br />FEE CURRENT
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<br />Address
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<br />COMPANY I
<br />REGISTERED
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
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<br />Address
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<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 on site, 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, .
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<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 cqntractor) or Power of Attorney (for the owner) would be SDmeone with notarized letter frDm owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
<br />
<br />License #
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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