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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 />Date Received
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<br />Owner's Name b ~J LA t+-
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<br />Owner's Address I 3 tJ, '10 I
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<br />Fee Simple Titleholder Namel
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<br />Ct>.
<br />, (t-5T
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<br />W .L\ ..{ t~L-U ::"'19
<br />Au2..
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<br />Owner Phone Number
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<br />7
<br />
<br />Owner Phone Number
<br />
<br />Fee Simple Titleholder Address
<br />
<br />~
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<br />LOT #
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN
<br />
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<br />MOVE D
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<br />DEMOLISH
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<br />OTHER 1p;.<iYLAC~ SH.l. l~ I
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<br />DESCRIPTION OF WORK !2.."i IV\OV G C) S 2 Ze $- I-( 1. \ W S t-\ L I rJ:>TA- U__ ::;:.3
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<br />BUILDING SIZE lOX 14" SQ FOOTAGE 140 SQ (.:,- HEIGHT ~ (../
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<br />'C71 BUILDING 1,$> ..) I
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I Q-,:~ ::;-:2. ,dO
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<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTAL~~O
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES
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<br />I YI N I FEECUR ENT
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<br />License # I
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<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />DNO,j (,501
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<br />BUILDER
<br />SIGNATURE
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br /> LIcense #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />License #
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<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 />Di~~~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)
<br />
<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 (PloVSurvey/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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