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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received lc .. \"3 -0 .~
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<br />Owner's Name Ii- ~n 0 / d bt.-AI, c, U/1
<br />Owner's Address I '19(:> I It; f L, 5-j
<br />Fee Simple Titleholder Namel fJ h" d d b ~ptL, 9- V\
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />?;13' 35"S-- '10} I
<br />Y/3 .' '3 () 9 ~cJbd71
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<br />Fee Simple Titleholder Address I CI '7t>1
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<br />/(,1<
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<br />Sf
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<br />JOB ADDRESS
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<br />49'c>1
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<br />16f~ ~f
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<br />LOT # I 00 / C)
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<br />PARCELID#lllf -2l,-~\ ~ 60\ 0- c>acoc> - 60\0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />I
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<br />D NEW CONSTR E3 ADD/ALT D
<br />D INSTALL REPAIR
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<br />PROPOSED USE D SFR D COMM D OTHER I
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<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I F EL1'..tu <3--
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<br />DESCRIPTION OF WORK I J j\) S 1 Il- L L ]: ~ I.JCf 1> -A- e-t 1 ~ l- ""9 St~d ~r
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<br />BUILDING SIZE I I sa FOOTAGE I '1 L1lt:7 i I HEIGHT I
<br />TfTTTTII' I I III , , , I . IIIII II , . I . II , t 11II , , I . IIII , . . . III t I . I III1 I 1IIII11 , IIIII , 1II1I1 III11II , IIIIII , I1I1IIIIIIII III1IIIIIIII1111 , III1I , , 1111111 r IIIII
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />D BUILDING 1$
<br />D ELECTRICAL 1$
<br />D PLUMBING 1$
<br />D MECHANICAL 1$
<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />ROOFING
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<br />I
<br />I
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<br />D
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<br />AMP SERVICE
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<br />G
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />\ iOO. ei()
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY ~ER pt7c; 't C~..5 --:3, r.
<br />FLOOD ZONE AREA DYES ~
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />/
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<br />#m~
<br />Y / N I
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<br />tJ UJA/ EX.-
<br />FEE CURRENT I Y / N
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<br />Address
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />ELECTRICIAN
<br />SIGNATURE
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<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 />
<br />Y/N
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<br />Address
<br />
<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />Address
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<br />MECHANICAL
<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 />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
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<br />License #
<br />1II11111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111
<br />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 subdlvisionsllarge 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.
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Di~~~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 , I . . I . . I
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<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)
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<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 PERMmlNG (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadwaysooneeds ROW
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