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<br />813-780-0020
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<br />City of Zephyrhills Permit AppliCation
<br />Building Department
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<br />'-eJ' u..c..
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<br />Fee Simple Titleholder Address I .5'Z 5 .:5 tl ff pi( M.
<br />3 8" ~3 () Pi ~ Ave,
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<br />E3 NEW CONSTR D ADD/ALl D
<br />INSTALL D REPAIR
<br />PROPOSED USE D SFR 0 COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME D STEEL D OTHER I
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<br />DESCRIPTION OF WORK I 0e1'\>'-1J l:k'll\ of b. QuO S-f y1~k.~ 'of o...J c1 C\~ IA fV' (' CU"\() p,/
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<br />BUILDING SIZE I I sa FOOT~GE I' I HEIGHT I I
<br />11111111 ' II , 111111111 I 1111111111111 11111 II 11111 III II I ' 11111111111 , 11111 , 1111111 ' 111111 ; . III . I , . III III 1111 ' III . 11111 1111111111111111111111111111111
<br />o BUILDING 1$ \ '2 oDD I
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<br />o ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />o GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ONO
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<br />1II1111111111111111I111111111111111111111111 ! 11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<br />:~~~~RE 1iL-n _ ~ ~ I ;.~~::::::; I 1 @ N ,EECURRENT ICI' Nil
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<br />Address ph (/ ~ ~ (c vvr.?lJ J .tJ'dl-e" WreJ 1t9~1 C!A. ,-"N/ r4 - ~Yj License # I CGc C)~ 06 <.f 6 I
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<br />ELECTRICIAN I I COMPANY I I
<br />SIGNATURE 11/"4 REGISTERED Y I N FEE CURRENT Y I N
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<br />Address I License # I
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<br />:~.:':.."r~~E I M1 ;.~=~~ y, N FEE CURRENT Y , N I
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<br />
<br />Address I License # I
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<br />MECHANICAL I /1 /' A COMPANY I
<br />SIGNATURE . / v i/+ REGISTERED Y I N FEE CURRENT Y I N
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<br />Address I License # I
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<br />OTHER I " /' /1. COMPANY I
<br />SIGNATURE /v/-l REGISTERED YI N FEE CURRENT Y/N
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<br />Address I License # I
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 />Fee Simple Titleholder Name
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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 />Date Received
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<br />Owner's Name
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<br />Owner's Address
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<br />JOB ADDRESS
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<br />LOT #
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<br />SUBDIVISION
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<br />PARCELID#lf(-)~-JI-f)OI O~ !b~o 0 -0060
<br />(OBTAINED FROM PROPERTY TAX NOTICE) ~
<br />SIGN D MOVE c:g- EMOLlSH
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<br />WORK PROPOSED
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.RE.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />DI~~~ti~~~': ' , , , I , , , . , , . . , , , , , , , . , , , . I , . , , , , , I , . . , , , , , . . . , , , , , , . , . , , I I , , . , , , . , , , , , , . I , , , . , , I I . . . , , , , . , , . . , . , , , , . , , , . , , , , , . . , , . , , , . , , I , , . . , , . . , , , , I I
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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. (AlC 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 (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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