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<br />~
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />81a-780-0020
<br />
<br />Date Received
<br />
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address I . g~ c;' Lf 2
<br />Fee Simple Titleholder Namel
<br />
<br />?'f?t <XtJ ~
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />39"yC(2
<br />
<br />A~
<br />
<br />c;{UP
<br />I
<br />B
<br />D
<br />D
<br />
<br />JOB ADDRESS
<br />
<br />LOT #
<br />
<br />PARCELlD#1
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />E1
<br />D
<br />D
<br />I
<br />
<br />D
<br />D
<br />D
<br />d~cI _-1plr~
<br />I
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />DESCRIPTION OF WORK
<br />
<br />c r:..~~"t <LJ/'. OCI' f
<br />/
<br />I sa FOOTAGE I
<br />
<br />BUILDING SIZE
<br />
<br />\ \ - 2l.a - 2.l - 00\0 - 1\000 -00/ I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />t3~~r
<br />
<br />HEIGHT I
<br />
<br />OTHER I
<br />
<br />TIT'"lllllflll"'-IIIII"""III"'."'."IIIIIIIIII'"1111111".'..1111111111111"'1111111"'11"111111111111""11111111"'11111111111111111111
<br />
<br />1$ I
<br />1$ I
<br />, /00 ,
<br />
<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
<br />
<br />I111111111111111111111111111II1111111111111111111111111111111111111111111111111111111111111111111111111111II11111111111111111111111111111111111111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />~ ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />D
<br />
<br />PLUMBING
<br />
<br />~PROGRESSENERGY
<br />
<br />D
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />License #
<br />1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsions/large 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.
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />I Y IN I
<br />I fE-('; CY;;6..2JJ?c) I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />DI~~~ti~~~': ' , , . . . . . . . , . , . . , . , , . , . . . . , , . . . . . . , . . , . . . . , , . , , . . . , . . . , , . . . , , , , , . . . . . . , , . , , . . . , , , , , . . , . . . . , . , . . . . . . , . , . . , , , , , , , . . . . . . . . . . . . . . . . , . . . . . . . .
<br />
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement is required. (Ale 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
<br />
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