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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />13> 773i
<br />I
<br />
<br />/ Cf I.... "4"'e-
<br />
<br />JOB ADDRESS
<br />
<br />PARCEL ID#I
<br />
<br />I LOT #
<br />
<br />\0 - 2~ ~ 21 - 0 CoOO. OCCOO~ odOlOl
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />E3
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />DESCRtPTION OF WORK 1:{;0 ~ " )(/ Vl ./l-rhr
<br />BUILDING SIZE I I sa FOOTAGE I I HEIGHT I I
<br />111"II'llln'II'IIPII'I"II'IIIIIIII'I'III'IIIIIIII'111'1111'11111'11'11111"1'11'111:'11'1"1'11'11'111'11'111111111'1111111111'1'11'11111'11111
<br />D BUILDING 1$ ~Oc..7 I
<br />D ELECTRICAL 1$ I
<br />o PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIII\IIII\IIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII1111111111111111111111111111111111111111111\111111111111111111111111111111111111111111111111
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />o
<br />o
<br />
<br />ADO/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.RE.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER ! ~'~
<br />SIGNATURE : -_ ~ - c '"
<br />Address
<br />
<br />~c:.. OC--n-er-
<br />Y / N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License #
<br />
<br />ELECTRICIAN
<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 />
<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 />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />111111111111111\11111111111111111111111111111111111111I11111111111111111111111I11111111111111111111111111111111II1111111111I1111111111111111111111
<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, Stormwater Plans w/ Sill Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 />Dl~~~i:i~~~': I , , , , . , , , , . , , , , , . , , . , . , , . , , , , , , , , . , , , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , . , , , , , , , , , , , . ~ ' , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,
<br />
<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 Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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