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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />t-aX-1l1,j-(IlU-UUL I
<br />
<br />Date Received
<br />
<br />
<br />"-"
<br />
<br />/I/' t /~ :s.
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<br />
<br />G e..~~.-V' . L1 /L; 'J(] /Z.- ci/lrr4/4 Owner Phone Number I
<br />I Owner Phone Number I
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<br />Fee Simple Titleholder Address I
<br />I ..s 14h1 {.
<br />I wt.,() 7~ WO Or,/
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<br />LOT #
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />PARCEL 10#1
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />DEMOLISH
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<br />DESCRIPTION OF WORK
<br />
<br />E3
<br />o
<br />o
<br />I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />WORK PROPOSED
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER I
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<br />HEIGHT I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />o
<br />
<br />
<br />D
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />ROOFING
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<br />SPECIAL TV 0
<br />
<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 , '.1 I I I . , , . I I , I . I . I I I , . . , I I , I' . I , , 1 II , I . , , . I , I I I , I , I I I , I , I . I , , . I I , , . . , . . I , . . , I I , . . i , I . I . . . I I r , I II' I ~ I , , I I . I , , , . I , , I I' , I I , , . , , , I I I I I , , , I II
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<br />BUILDER COMPANY I
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address License # I
<br />ELECTRICIAN COMPANY I
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address License # I
<br />PLUMBER COMPANY I
<br />SIGNATURE REGISTERED Y I N FEE CURRENT Y/N
<br />Address License # I I
<br />MECHANICAL ':z-/dL- COMPANY Ig4J1.t2 '..5 f/U'.;?;I/,v L 6'1 s e 11/c .rJL
<br />SIGNATURE REGISTERED I~YN I FEE CURRENT I ~ N I
<br />Address License # ICAe" Y'?9' Y R I
<br />OTHER COMPANY I
<br />SIGNATURE REGISTERED YI N FEE CURRENT Y/N
<br />Address License # I
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<br />I1I111111111I11 I111111111111111111111111111111II1111111111111111I11111111I11II11111II1111111I1111111111111111I111111111I1111111111111111111111111
<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 onslte, Construction Plans. Stormwater Plans wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslons/large projects
<br />COMMERCIAL 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 onslte, 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 />II11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111I1111111111111 i 11IIII11 t t i I i I111I
<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. (A1C 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 PERMITTING (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 roadways..needs ROW
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