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<br />Date Received
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<br />
<br />City of Zephyrhills Permit Application
<br />Building Departme~~ ';c
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<br />
<br />Phone Contact for Permittin ! / J
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<br />Fax-813-780-0021
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<br />813-780-0020
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<br />Owner's Name
<br />
<br />
<br />Owner's Address I ~ 0 J I
<br />Fee Simple Titleholder Namef
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<br />
<br />Fee Simple Titleholder Address I
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />'K;J"u~y \)(
<br />I
<br />
<br />JOB ADDRESS
<br />
<br />
<br />
<br />LOT #
<br />
<br />I.>?
<br />
<br />SUBDIVISION e. PARCEL ID#I 01, 2~. 2./- o/Jo-tJoooo - O~70
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED B NEW CONSTR B ADD/AL T D SIGN 0 MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I
<br />DESCRIPTION OF WORK I ""1t\5( 0 v",J l"u \ C'C~n,\ Pnv~ ~ ')
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I I
<br />
<br />11111111"'1111111111111111"".'111111111111111111111111".,.,11111111111111111'.'.1111111"","11111111111111111'1'1111111111111"1'11111111111
<br />
<br />1$ 91...\ I CJOb,(5D I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 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 />1I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />/lo'l. 5 CO L' N~". ,ic1:'NT I Y I N I ~ j:)
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<br />License # I c ( c.. I 'I ~ 7 J ~ ? I
<br />I
<br />I
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />
<br />Address
<br />
<br />ELECTRICIAN !
<br />SIGNATURE
<br />
<br />Address
<br />
<br />Address
<br />
<br />~
<br />/~
<br />
<br />,">"_ d"~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~rA+b F/,A,,'v
<br />I Y / N I FEE CURRENT
<br />License # I
<br />
<br />Y/N
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />'~7" _&->
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 onsile, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlslons/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 w/ 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 />Di~~~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 (Plot/Survey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
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<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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