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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 />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />- Owner's Name
<br />
<br />- Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />-JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />15203
<br />I
<br />
<br />tl%
<br />
<br />s+.
<br />
<br />LOT #
<br />
<br />I
<br />
<br />D NEW CONSTR m ADD/ALT D
<br />D INSTALL D REPAIR
<br />PROPOSED USE 00 SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />Xt'~la ci n~ Q tlrfltiOU>S
<br />
<br />BUILDING SIZE SQ FOOTAGE 1 I HEIGHT I
<br />111111111111111111111111111111111111111111'11'11'11111111111111'11"'11111111111111111"11111111111111111111111111111111111111111111111111111'1111
<br />[Xl BUILDING 1$ 230 0 I VALUATION OF TOTAL CONSTRUCTION J..)oi - t-\-\~ c.. ../
<br />,
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DN W
<br />
<br />1I1111111111111~1I1111111111111111~11I1I1I1I1I! IglIlIll ~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII; II111II111111II11I1111111I11I11111 ~III ~7111151 ~ 1I1I1I1111
<br />
<br />""UILDER ;" .-. COMPANY "A ~CJ"('nQ..cU.5Y\_a"'L ;,
<br />''i'GNATURE _ ~ a.-' _ , _ ___ _ _ .'""'''''D Y J N I m CO"",,, Y J N I
<br />
<br />Address _ I License #
<br />
<br />PARCEL 10#1
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL I xl
<br />
<br />OTHER I
<br />
<br />fA} i'/"It/OuJ..s..
<br />
<br />DESCRIPTION OF WORK
<br />
<br />ELECTRICAL
<br />
<br />o PROGRESS ENERGY
<br />
<br />~
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />D
<br />o
<br />
<br />AMP SERVICE
<br />
<br />
<br />'7
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ 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
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />License #
<br />11111I111111111111111111111111111111111111111111111111111I1I1111111111111111111111111111111111111111111111111111111111111111111111
<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 on site, 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~~~ii~~~': . , , , , , , , , , , , , . , , , , , , , , . , , , , . , , , , , , . . . . , , , , , , , , , , , , . , , , , , , , . , , , . , . , , , , , . . . . , . . , , , . , . . . . . , , , , . . , , , . , , , . , , , , . , , . , , . , , , , , , , , , , , , , , , , , . , , . , ,
<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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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