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<br />Fee Simple Titleholder Name
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<br />
<br />
<br />Fax-813-780-0021
<br />
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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received
<br />
<br />Owner's Address
<br />
<br />])r
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />XlA-t C
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
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<br />D
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<br />
<br />PARCEL ID#I 0.3 -2, (~--.2I--013~{)ZO:1.-a5Z 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />DESCRIPTION OF WORK
<br />
<br />E3
<br />o
<br />o
<br />I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />OTHER I
<br />
<br />C:-~ I r 1:&4 (1 FC,7C(:
<br />
<br />LII}('Q~ 1 I L.J I
<br />BUILDING SIZE5Q rSSTA6E -, 4 HEIGHT
<br />TTTTITJTTTTlIIIIIIIII" 11111'" 111111111111111111111"" 111'1'11111" '111111111' 11111"" 11111' 1111111111' '11111111'11111' 11111' 11111111111111' III
<br />
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<br />
<br />D BUILDING 1$ I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ 1
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111
<br />
<br />:~~~RE I C.J?WV
<br />
<br />Address I _ r t, ( 0
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />b-r~
<br />
<br />5+
<br />
<br />License #
<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 I N FEE CURRENT
<br /> License #
<br />Y I 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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />License #
<br />I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 subdivlsions/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.
<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 (PloUSurvey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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