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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 />2.-
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<br />0//42j'd ~61Rhfr'Ptrone Number r
<br />I Owner Phone Number I
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<br />Date Received
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<br />/' Owner"s Name
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<br />
<br />Va/eLM Ci~cb
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<br />Fee Simple Titleholder Address
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<br />LOT #
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<br />/' JOB ADDRESS
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<br />2 - 2-1,,-2../- Q;) I SJ - cxxm-
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />~W /,v,' Iv d
<br />sa FOOTAGE I
<br />
<br />/' DESCRIPTION OF WORK
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<br />BUILDING SIZE
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<br />111111'11111111111'11111111'1"11'111'111'111111111.1'11"111111111111111'111'11111111'1"'1'1'111'1'11'11111111'111"11111'111'1111111'111111'111
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />/1$
<br />D ELECTRICAL 1$
<br />D PLUMBING 1$
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<br />D MECHANICAL 1$
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<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />5/0
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />S'd/1
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<br />HEIGHT
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<br />BUILDING
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<br />.;1 0(:)0, 00
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
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<br />AMP SERVICE
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address License #
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<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111 J 1111111I11111111I1111111111111111111111
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<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 subdivisions/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 w/ 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 />
<br />ROOFING
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<br />
<br />BUILDER
<br />/ SIGNATURE
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<br />~ ....
<br />
<br />C~MPANY " I
<br />REGISTERED
<br />
<br />Address
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<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
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />OTHER
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<br />DYES
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<br />DNO
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<br />I Y / N I FEE CURRENT
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<br />Y/N
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<br />License #
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<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br />
<br />Y/N
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<br />Y/N
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<br />Y/N
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<br />Y/N
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<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)
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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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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