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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />#' (p -{aJ/~-780-0021
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<br />Date Received
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<br />
<br />(j~~70AJ
<br />
<br />
<br /><5r
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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 />Owner's Name
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<br />Owner's Address I ({JOf?..9
<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />I LOT# I 8s-
<br />PARCEL 1D#1t?3-.A~ ~J -02/0 -00000 - oBfJo
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
<br />D SIGN D MOVE D
<br />D
<br />D
<br />~Llae. L}fGtIfIWf-
<br />I HEIGHT I I
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<br />1$ qw~ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
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<br />1111111111111111111111111111111111111111 " 111111111111111111111111111111111111111111111111111111111111111111 " I " I " 1111 " II " 11111111111111111111
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<br />BUILDER I
<br />SIGNATURE
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<br />10c?61 &6~JtJ 5r:
<br />~~51y;1,U 1~
<br />
<br />E3 NEW CONSTR E3
<br />INSTALL
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
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<br />DESCRIPTION OF WORK I /j;-V fh7i? &ft.It/~
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<br />I SQ FOOTAGE I
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
<br />
<br />BUILDING SIZE
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<br />D
<br />D
<br />
<br />D
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<br />ELECTRICAL
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<br />AMP SERVICE
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<br />D
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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 />PLUMBING
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<br />MECHANICAL
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />I Y / N I FEE CURRENT Y / N I
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<br />~~;ti. ~ :
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<br />N FEE CURRENT Y / N
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<br />License # 19<DO/3. ~3- I
<br />€(l-~UJ C ~~ 1 I
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<br />FEE CURRENT Y / N
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<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Y/N
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<br />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIA
<br />SIGNATURE
<br />
<br />
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMMERCIAL
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />, II " II " III " 1111111111 " " 111111 " " II " I " I111111 " 11111111 " 11111111111111111111111111111 " 1111 " " 11111111 " " " 1111111 " 1111 " 11111111111111
<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 />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 w/ 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 />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
<br />
<br />111.11...11..11111..11111......111...........11.11.....111111......11...111..1111.11..1111....111....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
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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