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<br />I I
<br />813-780-0020
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />wner Phone Number
<br />
<br />C-owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />~ Owner's Name
<br />
<br />-- JOB ADDRESS
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<br />Fee Simple Tillehold~r Address
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<br />:
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<br />I
<br />;33~Ci..
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<br />o NEW CONSTR D ADD/ALT 0
<br />D INSTALL D REPAIR
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<br />PROPOSED USE 0 SFR 0 COMM 0
<br />
<br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0
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<br />_ DESCRIPTIONOFWORK I IJtI~~\~ ~'f..\.:i~.~ ~ kphklr
<br />
<br />Ii I SQ FOOTAGE I I HEIGHT I
<br />TTTTIT'T""""TTITTII ' ~ 111I . III , , 1I1111111 , , 1111111 , ' 1I1I1 , III1 ' II11 , I111111 ' 1111 , III , , I111 , I111 . I111I . . . II . , , ' 1II1 , III , III ' 1111 , , , ' I1I1 ' I11I1 ' IIIII
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<br />(! Q)u..vl~
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<br />K(i)A-L 5<1
<br />PARCEL ID#I
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<br />~ LOT> I
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<br />~;;( -.)6- Z/ - OD)Z)- D,bOOO-t)fD/O
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE 0
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<br />SUBDIVISION
<br />
<br />_ WORK PROPOSED
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I V
<br />
<br />BUILDING SIZE
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<br />D BUILDING 1$ J b J I)~D $0
<br />D ELECTRIOAL 1$
<br />D PLUMBINcB 1$
<br />D MECHANICAL 1$
<br />D GAS 0 ROOFING
<br />FINISHED FLOOR ELEVATIONS I
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<br />I
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<br />I
<br />o
<br />I
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<br />AMP SERVICE
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<br />o
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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 TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY 0 OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
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<br />Address
<br />
<br />
<br />License #
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<br />I CGcob G6 l( b
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<br />BUILDER
<br />SIGNATURE
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<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 />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />Address
<br />
<br />
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />1111I11111111111111I111111111111111111111111111111111111111111111111111111111111II111111111I1111111I1111111111I11111111I11111111II1111111111111111
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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 />COMMERCIAL I 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />DI~~~ti~~~': ' , . . , , . , . . . , , . . , , . . , , , . . , , , . . . , . , . , . . , . , , . , , , . , . . . . , . . . , , , . . . , , , , , . . , . . . . , , , . , , . . . , , , . , , . . , , , , , , , , , . . , , , , , , , , . , , , , , , , , . , , , , , , . . . . . . . . . ,
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<br />Fill out applicatIon completely.
<br />Owner & Contr~ctor sign back of application. notarized
<br />If over $2500, . Notice of Commencement Is required. (AlC upgrades over $5000)
<br />
<br />.. Agent (for the <t>ntractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNT~R PERMITTING (Front of Application Only)
<br />Reroofs ; Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Driveways-No. over Counter if on public roadways..needs ROW
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