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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />Owner's Name
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<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />135'l q TOurm~hn~ br.
<br />I~meya{d /1J1'rIt I< v' ~e5()rt1
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />JOB ADDRESS
<br />
<br />I LOT# I d.51
<br />
<br />PARCEL ID#I ~t..f - J.~ -;;'/-0010 -00000 - ~5qo
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />
<br />~
<br />D
<br />D
<br />
<br />D
<br />D
<br />D
<br />rtJoWl w/vln
<br />/:1-0 t:fi I
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DESCRIPTION OF WORK
<br />
<br />/Jdd .sCreen
<br />I SQ FOOTAGE I
<br />
<br />BUILDING SIZE
<br />
<br />10 'f.- /2-
<br />
<br />..11'...11...11111.................11....11111......11..111....11............11...............111111........11111'11.....1111.11111.111.11.1111111
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />/ w'YJdaw.5
<br />
<br />HEIGHT I
<br />
<br />OTHER I
<br />To eXtsf,-
<br />
<br />I aJ1.~
<br />
<br />[K] BUILDING 1$ SOt) 0 t/i!:- I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY c===J W.R.E.C
<br /> ~ :I
<br />D PLUMBING 1$ I
<br /> ~l/
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES c===JNO
<br />
<br />p . . . I . I I I I I . I I I I I , t I I , , , 1 . . , I I I I . , It. , . , , . , , I , . I . P , . , . , t . I . II t , , , , , , . I , , I , I I . . . I I II I , , . , I I . I , I , , , , I I , I P . ~ , . I I I . II , . , , I . I , I I t I , 1 I I , , , , , I , . I I . I I II t ,
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />o
<br />
<br />9I1Jn.e.,r ~Z. 75' ~
<br />I N I FEE CURRE I Y I N
<br />License # I
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<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Address
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<br />11I111111111111 1111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 subdivislons/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 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.
<br />111II1111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111I11111111
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A1C Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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