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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date 'Received
<br />
<br />
<br />CeL~
<br />Le('9A C-r,
<br />
<br />
<br />Owner Phone Number
<br />
<br />OWner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address I 232. 7
<br />Fee Simple Titleholder Namef
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />JOB ADDRESS
<br />
<br />I 7.7.:27
<br />I fii/')~
<br />J'
<br />
<br />SUBDIVISION
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<br />
<br />LOT #
<br />
<br />PARCELID#13 S -2'5 - L\ ~o05A - 00000. (Co~ I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />
<br />OTHER I ~7r70;,/1I-r-!~;/",....
<br />STEEL D OTHER I
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />I ----- .
<br />DESCRIPTION OF WORK ::J-,/l/J~ (I ..:::;z::;'/'lr, :.,;:/!-71 './-'V , ('V, h ~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I' HEIGHT I
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<br />
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />D
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D AMP SERVICE D PROGRESS ENERGY D W.R.E.C,
<br />
<br />D
<br />
<br />D VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />11111111111111111I11111111111111111I11111111111I11I11I111I11111111111111111I11111111111111111111I1II111111111I11111111111I111111111111111111111111
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<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 />I
<br />z- f/, $ License # II- ,55"-- 8? I)
<br />
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<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 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 on site, 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 />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />ca--.
<br />69'i'l II ~ >/
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<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)
<br />
<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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