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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />JOB ADDRESS
<br />
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />o~one Number <?lo - 1\ ~ - D I K. '
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<br />Owner Phone Number L I ~
<br />
<br />Owner's Address
<br />
<br />C~
<br />
<br />DESCRIPTION OF WORK
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<br />Mo
<br />I
<br />
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />!&1
<br />
<br />SIGN
<br />
<br />D
<br />
<br />DEMOLISH
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<br />B
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
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<br />lit S5D,~ I
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D 1$ ,. .I~___CP-~
<br />MECHANICAL . VALUATION OF MECHANICAL INSTALLATION ~ /Jot, -
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<br />D GAS D ROOFING D SPECIALTY D OTHER 0 ~"r"---
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
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<br />BUILDER ( n . ..Ai J r .. COM~ANY I R ptrs. S:?", G,.-p I
<br />SIGNATURE CXtA "" It 'f4 REGISTERED Y I N I FEE Cl1RRENT I Y I N I
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<br />License # I f"SOOoo q.t7
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<br />OTHER I
<br />
<br />BUILDING SIZE
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<br />,,'
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />I ~o~~r~
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<br />S~h U~~
<br />I T FEE CURRENT I Y I N I
<br />
<br />License # I ~ S Or> VoL/I?
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I 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 />Address License #
<br />1111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 subdivlsionsllarge 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 />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 NC
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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