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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />o
<br />e -ten BR) (\ ,
<br />Owner's Address I 105 D q (I If IfI7t L~ 12 {} /10
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<br />Fee Simple Titleholder Namel
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<br />Owner's Name
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<br />Fee Simple Titleholder Address I
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<br />140501 (!II4IJC l7Cf lZo/Jl:]
<br />I n fA I PARCELlD#1
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<br />,
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<br />D NEW CONSTR m UJ5i))AL T D
<br />D INSTALL D 'R€PAIR
<br />PROPOSED USE D SFR [E COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME c=J
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<br />DESCRIPTION OF WORK LPA-n K Q:) F / 6f<1562€ liJ ~
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<br />BUILDING SIZE I sa FOOTAGE I l-& 0 I HEIGHT I
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<br />JOB ADDRESS
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<br />LOT #
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />I
<br />00
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<br />OTHER 14l-iA.rnlnL{.m
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<br />D BUILDING 1$ &L.f t)O, 00 I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />BUILDER
<br />SIGNATURE
<br />Address
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<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 />ELECTRICIAN I _________
<br />SIGNATURE .
<br />
<br />Address I
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<br />PLUMBER I ~
<br />SIGNATURE ______
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<br />I
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<br />SPECIALTY D OTHER
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<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />License # 18et 18/ J'II/€3jt!
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<br />COMPANY
<br />REGISTERED
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<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 />
<br />Y/N
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address
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<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 />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 wi 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.
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />SIGN PERMIT
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<br />DI~~~ii~~~': ' . . . , , , , , , , . , , , . , , , . . , . , . . , , , , . , , , , . , . , , , , . , , , . , , , , , . , , . , . . , , , , . . . , , , . , . . , , . . , , , , . , , , , , , , , , . , , . , , , , , . , . . , , , , , , , , , . , , . , , , , , , , , , , , , , . , , , ,
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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)
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<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)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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