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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
<br />
<br />
<br />,; Owner's Name ... J'
<br />
<br />/ Owner's Address I "3 '8' 7 () a
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I S" I :3
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address' I
<br />
<br />'J<g70?{
<br />
<br />/ JOB ADDRESS
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<br />9 r /I A 1j<', /:r~/r~j, ,ils PI 53~1t'2
<br />
<br />I PARCELlD#1
<br />
<br />E3 NEW CONSTR r=:J ADD/ALT 0
<br />INSTALL D REPAIR
<br />PROPOSED USE 0 SFR D COMM 0 OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D
<br />
<br />r DESCRIPTION OF WORK I < -"plac, < ,.,1,/ c"""<-r...;t,,t~ 'j P n ,..M~ C" .-hht dW/.r,
<br />
<br />BUILDING SIZE I I SQ FOOTAGE, __ HEIGHT I I
<br />111111'111'111'1111111111'111'1111111111'111'1'111"11II'Illlllt"I'I.,111111111111.'ll.I.III'III'1111111111111,llr"IIIIII,IIIIIIII'.IIIIIII"11111
<br />
<br />LOT #
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<br />SUBDIVISION
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />D GAS
<br />
<br />/:: <2 t/ ~e
<br />
<br />1$
<br />1$
<br />
<br />o ROOFING
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />~UATION OFTOTAL CONSTRUCT'ON
<br />AMP SERVICE D PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />I
<br />I
<br />D
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY 0 OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
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<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />
<br />
<br />
<br />
<br />BUILDER
<br />/ SIGNATURE
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<br />~ ~/?7t1' A/?~.~
<br />I Y / N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />11111I111111111111111111111111I111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111II
<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 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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />i:ii~~~ti~~~': . , , , , . , I , , , . I I , , , , , , , . , , , , . , , , , , I , , . , , I , , , I . , . , I I , . , I . , , , , I , , , , . , , , , . , I , , . . , , , , , , I , . . . , , , , , , . . , , , , , , , I , , . , , , I I , . , . . . . . , . , . , , I , . , I , , . . , I
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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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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