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<br />813-780-0020
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<br />
<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 />Fee Simple Titleholder Name
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<br />Owner Phone Number
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<br />Owner Phone Number L
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<br />Owner Phone Number I
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Address I
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<br />\30;"</ 1 (v1~a_)J~W0<9J
<br />1fi1~~dcl4(i1o~ Es~k5 I
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<br />SUBDIVISION
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<br />J....OOf-J
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<br />PARCELlD#1
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<br />I
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<br />LOT #
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<br />JOB ADDRESS
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<br />/3 -:2'- -;:2. I-() Iv 0 --. 00000 - 09 yo
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />a
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE c=J
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<br />DEMOLISH
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />E3
<br />18:
<br />c=J
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />OTHER
<br />STEEL
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<br />I
<br />o
<br />
<br />OTHER I
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<br />
<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 />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/ N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address I
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<br />~::.:':TURE I~ ;if: 4--fl
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<br />
<br />Address I 37,",;:2S- S~k ROQcl sy License # Ice (! 0'/9570
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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/ Slit 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 />
<br />License #
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Di~~~ti~~~':' , . , , , , , , , , , , , , . , , , , , , , , , . . , , , , , , . , , , , , . , , , . . , , , . . , , , . . , , , . . , , , , , , . . , , , . . . , , , , , . , , '. ' , . , , , , , , , , , . . . , , , , , , , , . . , , , , , , , , , , , , . , , , . , , . , , , , , . 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)
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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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter If on public roadways..needs ROW
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