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<br />818-780-0020
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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 />I ~3 S:7j
<br />Owner's Address PD. ~ Z.15l/ ZEPI-IVRHIUS j:L
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />Owner Phone Number S I 3 - I
<br />Owner Phone Number I ~ I 3 . 783 .. ~ 7 ~ 7
<br />Owner Phone Number I <('13 - '7Jl)-S52~
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<br />Date Received
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<br />Owner's Name
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS 5329 4 lJ-J s, z..c.. pH YI?H ILLS .J;(.. 3354Z- LOT #
<br />SUBDIVISION I PARCEL ID# I /1- 2f..p . 2./ - DOl b - r>c, ~ ~ ~O '1' h
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED B NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
<br />
<br />DESCRIPTION OF WORK 10 "t- APPLY IloSQ 30~~ 0,.," SH PI. 70()(.. I 1-p'-y /'H()/)/f:"J€1) '3; mJ;fI!V Fi. $Z26
<br />
<br />BUILDING SIZE I SQ FOOTAGE I 2.100 HEIGHT I
<br />11111111111111111111111111111111111111111111111111111111111'11"11111111111111111111"1111111111111111111111"11111111111"1111111.11111111111111'1
<br />
<br />
<br />1$ 7{.,(P6. 06 I
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<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
<br />
<br />D GAS ~ ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />1I11III11I111111111111I11111111111111111111111111111111111I11111111111111111111111111I111111111111111111111111111111111I1111111111111111111111111I
<br />
<br />D
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />
<br />
<br />FEE CURRENT
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<br />Address IY]
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />13 '7c..'f
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<br />COMPANY I
<br />REGISTERED
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<br />License #
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<br />Ice~058Z27
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />1I111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 wI 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 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.
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<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
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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 (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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