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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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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
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<br />Owner's Name t2. /
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<br />Owner's Address 1.53/ /l LJi/7//?/l R ~# ;;( :,iZd' :5 :5'6"J
<br />Fee Simple Titleholder Namel I
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />I "/1.:2/
<br />I
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<br />..1:" z/, s;: ;/~ /~&f
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<br />I PARCELlD#1 /.I/":X.6 -.?:/ 'L1d/~ -ty/,5-?//,? /' ('~1?o
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR II ADD/AL T D SIGN D MOVE D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER Idl;:;_;; .T)' ~_
<br />TYPE OF CONSTRUCTION D BLOCK 00 FRAME D STEEL D OTHER I
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<br />DESCRIPTION OF WORK I 5" ~Vl'~;'J ~ 4./l'/?~/ ~ /:5t:J c7.~
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<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT
<br />111'11111111111111111111111111111111111111' , 11111111111111111111111111111111111111111111111111111111111I1 , 1111111111111111 , 11111111111111111 , 11111
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<br />LOT #
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />DEMOLISH
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<br />1$ I
<br />1$ /~jo,/JCT I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ 1
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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 />I1II1111111111111111111I1111111111111111111111111I1111111111111I11111111111111111111111111111111111I111111111II11I1111111I111111111111111111111111
<br />
<br />D
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />IX]
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<br />ELECTRICAL
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<br />AMP SERVICE
<br />
<br />~
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<br />PROGRESS ENERGY
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<br />[Z]
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />I
<br />I
<br />~~~f ~~~
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<br />COMPANY
<br />REGISTERED
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<br />Y I N
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<br />FEE CURRENT
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<br />Y/N
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<br />BUILDER
<br />SIGNATURE
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />License #
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<br />I~~~~: IY/NI
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<br />License # I~c /S t'c1 ~ ,:)-:1 ~
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address License #
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<br />111111111111111 1111111111111111II111111111111111I111111111111111111111I1111I1111111111111I1111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL 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 subdivisionsllarge projects
<br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />DI~~~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)
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<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 (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadwaysooneeds ROW
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