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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
<br />
<br />Owner's Address I ~ J If g :) 3 {il sf,
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />Owner Phone Number g;.3 73).,
<br />Owner Phone Number I
<br />Owner Phone Number [
<br />
<br />Fee Simple Titleholder Address
<br />
<br />I ),5"l.{f( dSr~ sf
<br />I ~2~ 1-k'1'r/dt
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<br />
<br />
<br />i-
<br />
<br />TYPE OF CONSTRUCTION D
<br />DESCRIPTION OF WORK I L K-{ ~!>U+ .<1.') ~s /) a
<br />BUILDING SIZE I ISQ FOOTAL I HEIGHT I I
<br />Q?'':; ~~,~~;~~ ' · , . . . . . 'I~ ';" [,' 'f': ~~' ' · , , , " , , i' , , , : :~~~~;~~ ~~'~~~~ ~~~~:~~:~~' , ' , , , , ..,., , , , , ' , ,.. , , , , , , , , , . . , . " . , ""
<br />1$ I
<br />1$ I
<br />1$ I
<br />D GAS g ROOFING 0
<br />FINISHED FLOOR ELEVATIONS/ I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PROPOSED USE
<br />
<br />D
<br />D
<br />D
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />I
<br />
<br />I
<br />B
<br />CJ
<br />D
<br />
<br />LOT# I '1, S-
<br />,
<br />
<br />PARCELID#II)~ :1&'-)'} - m'XJ~~~C'O ~()
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />o
<br />o
<br />D
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY c=J
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />[:JNO
<br />
<br />I , , I I" 'II II III , II' , , 11111111111111 . , 1111 ' III' II , " I' 111111111 . , .. 1111 . 1111 " 11111' , " III" .. . I' II" , III . 11111 .. 11111 , 111111111 ' III 111111111 .. 1111
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> license #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> license #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />II J 11111I1111 1 1111 1 1111111I11111111I 1 III 1 1111 1 1 111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Silt Fence Installed,
<br />Sanllary Facilities & 1 dumpster; Site Work Permit for subdlvlsionsllarge 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 onslte, 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 />11111111111111111111111111111I1I1111111111111111111111111111/1111111111111111111111111111111111111111111111111111111111111111I1111111111II11111111
<br />Directions:
<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 auUlOrlzing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroors Sewers Service Upgrades A/C Fences (PloVSurvey/Footage)
<br />
<br />OTHER
<br />SIGNATURE
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<br />
<br />Address
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<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
<br />
<br />
<br />license #
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