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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 />t-ax-tl1 j-(l:lU-UU:ll
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<br />P\d~ ~ r3.
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<br />Phone Contact for Permitting
<br />/ c\ ,/. (" ,', ~\~"'Y'-D
<br />~\<"s {r:r-'(("\,u__:, Owner Phone Number
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<br />fA"". r ( &-I'VE. Owner Phone Number I
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<br />Owner Phone Number I
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<br />Owner's Address ~ '? J 0 \
<br />Fee Simple Titleholder Namel
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<br />Date Received
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<br />Owner's Name
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address
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<br />I $"'C; 30
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<br />k'p"-~ ~ dt~ /Fe... '31.s~l{6 l.OT # I
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<br />I PARCELID#I \\ -2(P-2\ - ODiO- 00700 -- 0:2-2-0 I
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
<br />D NEW CONSTR r==:J ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH
<br />D INSTALL D REPAIR
<br />PROPOSED USE 0 SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK 0 FRAME 0 STEEL D
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<br />DESCRIPTION OF WORK I t==l &Lt. v+t...~ c;.yc;r"li.,~ I ~ , ro""'~
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<br />~~:~~.'~~,~~".. ,I", ~~.~ ,,;., ~,,),'" ,~~ ~~~~?;,!,"" """""""" ,I"" ,~~I~':!.,!,,' ~.~, ,~""" .1."""......."".... ,
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<br />o BUILDING 1$ lo \7CLO-o VALUATION OF TOTAL CONSTRUCTION
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<br />o ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY D W.R.E.C,
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<br />o PLUMBING 1$ "/~L\ 0.(:. Curct ~+ ,
<br />. -\.13~\ 6l'-C-\< c* ~rm d-
<br />D MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION,;A~
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<br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO PI ~ ~I r:j fY'\ ./
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<br />~~:~~~~' ,."""""..""".."""""...,."'."""""",,,""" :~~~~:"""""..""""""""""..""""""""""""'" 'I
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<br />SIGNATURE REGISTERED Y / N FEE CURRENT Y / N
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<br />License # I I
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<br />OTHER I J/VJ ,0 I _ COMPANY I S 6At trMr<- 5! c...v.-&.,~ I
<br />SIGNATURE /' l ~ ~ REGISTERED I Y I N I FEE CURRENT I Y I N
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<br />Address I '335"0 u C-Wl 14.,.,.... tt..-l CA 'L~ ~ 3 J ., I,&. License # I
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 onslte, 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 w/ 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.
<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111III i 1111111111111111111111
<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 />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />OVER THE COUNTER PERMmlNG (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A1C
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<br />~sr
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />OTHER I
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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
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<br />Y/N
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<br />Address
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<br />License #
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />YI N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />MECHANICAL
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/ N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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