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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 />Date Received
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />176;23 ~~c. 8Lt::/2:>
<br />I
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<br />Owner Phone Number
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<br />Owner Phone Number L
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<br />Owner Phone Number I
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<br />JOB ADDRESS
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<br />I
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<br />LOT #
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<br />SUBDIVISION
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<br />PARCEL ID#13 SL- ;L..)-.:2...I- ~././ 0&000 ~ 00/0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
<br />
<br />I
<br />
<br />
<br />~ NEW CONSTR [:=J ADD/AL T
<br />D INSTALL c=J REPAIR
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<br />PROPOSED USE D SFR ~ COMM
<br />
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME
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<br />DESCRIPTION OF WORK I //Z/? t:~C C T.s +- C) tt' r ~ r- S
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<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />TTTfTlllllllllllllllllllllllllllllllll , I1111I1111111111 , I , 1111111111111111111 , I111111111111111 , , 1111111111111111 r , III ' , 11II1111111111111111111 , II ,
<br />
<br />D BUILDING 1$ I
<br />..-::::::J.-- ELECTRICAL 1$ I
<br />~ ~(OO. 170 ,
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111I1111111111111111111111111111I11111I11111111111111111111111111111111111111111111111111111
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<br />WORK PROPOSED
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
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<br />AMP SERVICE
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
<br />
<br />D
<br />
<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 />Address
<br />
<br />
<br />MECHANICAL I
<br />SIGNATURE ,
<br />
<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
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<br />1I11111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<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 subdivisionsllarge 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 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 />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Y/N
<br />
<br />Y/N
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<br />FEE CURRENT
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<br />License #
<br />
<br />~J C~C7-e~C-
<br />IY / N I FEE CURRENT
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<br />License # I
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y / N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />Di~~~tj~~~':' , , . . , , , , . , , , . . , , . . . , , , . . , . , . . . . . , , , . . , , , . . , . , . . , , , . . . . , . . , , . . . . . . , , , . . , , , . . . . , . . . . . , , , . . , . , , , , . . , . . . . . , , . , , , . . . . . , , , , , . , . . , . . , . , , , , , . .
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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 (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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