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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 />Date Received
<br />
<br />
<br />
<br />d -~I-07
<br />
<br />/Owner's Name :::5 UA r-. f\ \I e rO-~
<br />/ Owner's Address I 5'1S Y (,., { lo -+" s.\-
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address
<br />
<br />/ JOB ADDRESS
<br />
<br />6<g~lo
<br />
<br />llo -t'V\ s-\-
<br />
<br />LOT #
<br />
<br />PARCEL ID#I
<br />
<br />SUBDIVISION
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />
<br />Il='eY'Ce... .-C-ro-lnu"IG 4'
<br />
<br />I SQ FOOTAGE I lr; 0 I
<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 />I
<br />
<br />BUILDING SIZE
<br />
<br />1111111"11111111'1111111'11111111'1111111'11."111111'1,,11111"1111"'1111111'11111'11111111111"'1111111'IIIIIIP'IIII'IIII'IIIIIII"IIIII.IIIII
<br />
<br />I' 1$ 3cD, C5D I
<br />1$ I
<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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />o
<br />
<br />D OTHER
<br />o STEEL 0
<br />
<br />( (PD -t:..., \ ""\Q~ .Q..)
<br />
<br />I HEIGHT I
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />License #
<br />11111111111I1111111111111111111I1111111111111111I1111111111I111111111111111111111111111111111111111111I111111111111111111I11111111
<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 w/ 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 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~~~ij~~~':' . , , . . . . , . . . , , . . . . . . , . , . . . , , . . . . , , . . . . , , . . , , . . . , , . . . , , . . . , , . . . . , . , . . . , , , . . . , , . . . , , . . . . , . . . . . . . . . , , . . . . . . . , . , , . . . . . . , . . , . . , , . . . . , , . , . . . ,
<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 NC Fences (Plot/Survey/Footage)
<br />
<br />BUILDER I J -r
<br />ISIGNATURE ~ {~~
<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 />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
<br />~r~
<br />Y / N FEE CURRENT
<br />
<br />License # I
<br />
<br />Y/N
<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 />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
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