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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />Date Received
<br />
<br />
<br />'Zeph::l rh i I ~
<br />
<br />Owner's Name
<br />
<br />OWn.e. Add'." I 5S'.5[
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address I
<br />Ig<iSS'i?
<br />I
<br />
<br />Galj
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />8J3- 7ag-lc47 -6
<br />&.to'}... '7q~-qO~ e -aJl~
<br />40')-log'}- 3/45 -r~
<br />I
<br />I
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<br />
<br />JOB ADDRESS
<br />
<br />(;,0..-'. \ 610d
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<br />B
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<br />+en-tsoJe.
<br />sa FOOTAGE I J800
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />PARCELID#11I -21p-;)..)-DOJO-00900 -00 II
<br />(08T AINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />B
<br />
<br />. PROPOSED USE 0
<br />TYPE OF CONSTRUCTION 0
<br />
<br />tern
<br />130' xloO' I
<br />
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<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />WORK PROPOSED
<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 />
<br />BUILDING SIZE
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />I
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<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />,;L
<br />
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />D
<br />
<br />PLUMBING
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />License #
<br />11111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111I1I111111111111111111
<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 subdivisions/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 />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 />"
<br />
<br />, OTHER
<br />SIGNATURE
<br />
<br />~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~
<br />
<br />a-
<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 />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/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 />YI 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. (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
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
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