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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 />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number L
<br />
<br />/ Owner's Name
<br />
<br />/ Owner's Address I 5;) ~S-
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />Fee Simple Titleholder Address' I
<br />
<br />2[1'11 fILII /4. S
<br />
<br />/ \JOB ADDRESS
<br />
<br />.91- rnL-
<br />
<br />LOT #
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />CJ
<br />CJ
<br />
<br />PARCEL ID#I \ \ - ~lo ..,), t- DOt 0- 'C\ 500 - 60 \ 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />D
<br />D
<br />I
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />CI/A 1/lJ
<br />I
<br />
<br />J- //V/( Fe jl/C!-L
<br />SQ FOOTMfE I I 00
<br />
<br />HEIGHT I
<br />
<br />, DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
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<br />
<br />, =~~~~RE JI ~J?J ~
<br />
<br />
<br />Address 1
<br />
<br />/ 1$ <30 () , rD I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING CJ SPECIAL TV D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES CJNO
<br />
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<br />
<br />COMPANY/ I .\-\0Y""n.Q C~~V
<br />REGISTERED I Y I N I FEE CURRENT
<br />
<br />License # I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />AMP SERVICE
<br />
<br />CJ
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Y/N
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI 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 />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111I1111111111I11I1111111111111111111111I111111I1I1I11
<br />
<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 wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />DI~~~ti~~~': . , , , , , , , , , , , , , , . , , , . . , , , , , , , , , , , . , . . , , . , . , . . , , , , , , , . , , , , , , , , , . . , , , . , , , , , , , , , , , . , , , " ' . , . , , , , . , , , . , , . . , , , , , , , , , , , . . . , I . , I I . , , , , , . . , . , , , , .
<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
<br />
<br />OVER THE COUNTER PE:RMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage) .,
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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