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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
<br />
<br />Owner's Address 13 ~ 1- (0 ()
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />o oJ lOA
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<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />3~Lffo()
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />( 6 ft-v n.. /A.A) 0 cf
<br />I PARCEL ID# I 0 2
<br />
<br />B
<br />D
<br />D
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<br />SQ FOOTAGE I 0 () ~ 1--
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<br />PI
<br />
<br />3rtS'f -3g'l~ 0 I
<br />-2. (p- 2- J -eLf () -00000 - f/ Va
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE c=J DEMOLISH
<br />
<br />COMM
<br />FRAME
<br />
<br />c=J
<br />c=J
<br />c=J
<br />
<br />DESCRIPTION OF WORK
<br />
<br />B
<br />c=J
<br />D
<br />1(4
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<br />ADD/ALT
<br />REPAIR
<br />
<br />WORK PROPOSED
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<br />VOT> {
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<br />OTHER I
<br />STEEL 0
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<br />3D 'jLttlr
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<br />HEIGHT I
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<br />OTHER I
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<br />I
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<br />
<br />BUILDING SIZE
<br />
<br />D
<br />
<br />D
<br />D
<br />D
<br />
<br />1$ II 3 b 0 I
<br />1$ I
<br />1$ I
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<br />D GAS ~ ROOFING D SPECIALTY c=J OTHER
<br />FINISHED FLOOR ELEVATIONS 1 I FLOOD ZONE AREA DYES DNO
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<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<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 />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<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 />OTHER J f?J ~~~ COMPANY
<br />SIGNATURE ~ ~ --- REGISTERED FEE CURRENT
<br />
<br />Address 1--:7:3 0 (() 5 ~S L ..)J1'W fl-.nV/ ']3r-7b I License # IcccO) 79.\ 7
<br />
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<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, Storm water Plans w/ Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 w/ 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 />
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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 AlC
<br />
<br />~
<br />*
<br />~
<br />
<br />Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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