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<br />-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Owner's' e
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<br />Owner's ~ddress I >iuLt 2. \
<br />
<br />Fee Simple Titleholder Namel
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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
<br />
<br />Date Rl
<br />:m:m:r
<br />
<br />d . .). -, - 0 7
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />Yo 4\ 5
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<br />'?>L.D Gs 3
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<br />LOT #
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
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<br />B
<br />D
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<br />SUBDIVISION
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />ADO/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />BUILDING SIZE
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<br />B
<br />D
<br />D BLOCK
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<br />D
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />DESCRIPTION OF WORK
<br />
<br />SQ FOOTAGE I
<br />
<br />HEIGHT I
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<br />11111"111111"1,,111111"'1111111111111111,1"'111111'11111111,,11111111'1111111"1111'1111'1"11111111111111111111"'1111"11111"'.'1111'111111
<br />
<br />D BUILDING 1$ 2c>C:;x:::>, crD I
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<br />D ELECTRICAL 1$ I
<br />. 15Db. C50
<br />r-. PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111111111111111111111111111111111111111'11111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111
<br />
<br />V:~~~~~RE 10~trJ rf~FEE CURRENT @N I
<br />
<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.R.E.C,
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<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />v:LECTRICIA
<br />SIGNATURE
<br />
<br />
<br />
<br />PLUMBER
<br />t/ SIGNATURE
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<br />License # lEe -ck7V ....2.??8
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<br />I~~~~t t{~~E~'~~RbT ~~. I
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<br />License # Icfc ll..f~
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<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />LIcense #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />1111111111111111111111I1111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111
<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 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Dl~~~ti~~~': . . . , , , , . , , , , . , , , . , . , . . . , . , . . , , , . . . , , , , . . , , . . . , . , . , . . . . . . , . , , , , . , , , . . . . . , , , , , , . . , . , , , , , , , . . . . . , , , , , , , , , , , . , . . . , , , , , , , , , , . , , . . , , , , , , , , , , ,
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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 Attomey (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 NC
<br />
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<br />I(:'j
<br />
<br />Via
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<br />Fences (PloUSurvey/Footage)
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<br />...~ \ \
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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