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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Owner.s Name ;{4 :mDAld i rYll4/L DoE
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<br />Owner's Address I 5& 15 t3E'EC I. 5-1
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<br />Fee Simple Titleholder Namel
<br />
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<br />3 "'}<6 -0 I
<br />
<br />
<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 />Date Received
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<br />Fee Simple Titleholder Address I
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<br />JOB ADDRESS I !)tJJ {'5 IS EEcJ,
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<br />I
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<br />DESCRIPTION OF WORK
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<br />(; Icc-bu c
<br />
<br />I
<br />B
<br />o
<br />o
<br />
<br />mdE"/C.
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<br />LOT #
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<br />
<br />PARCELlD#112 2(0 Z' {JOwlS OOOOU 802.0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />o SIGN 0 MOVE 0 DEMOLISH
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<br />
<br />o OTHER I
<br />o STEEL 0 OTHER I
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<br />5-1-
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<br />SUBDIVISION
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<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I
<br />11"1'11'1'11111111111'1'1111'1111"111111111'11111'11'1111"1'1"1'11'11'11'11'1111'1;11111'1'1'11'1"1111'11'1111'1'1'111111111'1111'11111111111
<br />
<br />B
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<br />I fq;It-1 C~
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />D BUILDING 1$ I
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<br />[X] ELECTRICAL 1$ '-/'5D c=- I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111111111111111111111111111111111111111'11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCe::,TI.ON
<br />~
<br />AMP_SERVICE 0 PROGRESS E~
<br />I :'J 0 ---------
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y I N FEE CURRENT
<br /> License #
<br /> r/rL-//(' I (
<br /> FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />
<br />(l~
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<br />
<br />
<br />
<br />OTHER
<br />SIGNATURE
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<br />Y/N
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<br />?3ssl
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />1111111111111111111111111111111111111111111111111111111111111111111111111I1111II111111I1I11111111111I1111111I1I11111I1111111111111
<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 onslte, 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 />COMMERCIAL
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<br />SIGN PERMIT
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<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewer~. Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not olier COl.Jnter if on public roadways..needs ROW
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