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<br />813-780-0020
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<br />City of Zephyrhills Permit Application 1_)'1><
<br />Building Department ~ II
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<br />Fax-813-780-0021
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<br />Fee Simple Titleholder Name
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<br />Owner Phone Number '1;'("3 - b u2- 3{~ I (,c
<br />Owner Phone Number I
<br />Owner Phone Number I
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<br />Date Received
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<br />Owner.s Na"le
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<br />Owner's Address
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<br />Fee Simple Titleholder Address I
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<br />Itp~~1
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<br />JOB ADDRESS
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<br />()oJLc.x~sl
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<br />w~ ] LOT# I
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<br />PARCEL ID#162 -2 b- 2/-6 2S 0 - 0 't0DOD -DO 9fJ
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />MOVE 0
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<br />I
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<br />E3 NEW CONSTR r-;a- AD DIAL T
<br />INSTALL CJ REPAIR
<br />PROPOSED USE 0 SFR 0 COMM
<br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME
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<br />DESCRIPTION OF WORK I ~ ~ L cJ I 2 }(.;L l.l
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<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I
<br />ITI'I"I'I'IIIIIII'II'IIIIII'IIII'II'I'II'I"II"I'I'II'111111'111'11'1111'1111'111'11;111"111111"'11'1"1'11'1'1'1"'1111'111111"1'1'11'111'11
<br />o BUILDING 1$ (;, UO 0 c...~ I
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<br />o ELECTRICAL 1$ I
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<br />o PLUMBING 1$ I
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<br />o MECHANICAL 1$ I
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<br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />111111111111111111111111111111111I1111I11111111111111111I11I111111I11111I11111111111111111I1111111111111111111111111111111111111111111111111111111
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<br />qo ~rD COMPANY I Ht/yYU:. ["'Ju.-/lU---V
<br />REGISTERED Y / N I FEE CURRENT
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<br />SUBDIVISION
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<br />SIGN
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />OTHER
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />WR.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Y/N
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<br />BUILDER
<br />SIGNATURE
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<br />Y/N
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<br />License #
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br />
<br />Y/N
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<br />Address
<br />
<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
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<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 />Address License #
<br />111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111II1111111111I11111111111111111111111111111111111111111
<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 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 />COMMERCIAL
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<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)
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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 NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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