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<br />813-7'80-0020
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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 />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />1'706ln ~{"Ie~
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<br />PARCEL 10# 13L) - d S -'d )- 0 )<60 - (:;cooo - 3d 00. I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
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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 />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />DEMOLISH
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER I
<br />STEEL ~
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<br />OTHER I ,n6bi \e. mnrr
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<br />DESCRIPTION OF WORK
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<br />1$ LL,50. I
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<br />1$ I
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<br />1$ (OOO.oC) I
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<br />1$<-\,500. I
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES 5;ZJNO
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<br />111111I111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111I111111111
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<br />~ BUILDING
<br />G' ELECTRICAL
<br />0-- PLUMBING
<br />~ MECHANICAL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />IZJ
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<br />PROGRESS ENERGY
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMMERCIAL
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<br />~~~~~~RE I ~~ I
<br />Address I ffi~:;S<=6 ~ ~. '1 +II \\:5
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<br />Address Ra~ UJ. )V\eClYJ(iO \, .~\~. I.-G).~}:url
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<br />PLUMBER !~~ ~ COMPANY
<br />SIGNATURE REGISTERED
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<br />Address' 3 . 1-- I S
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<br />MECHANICAL rJ]). . -^ ~"...~ h ^ l. I COMPANY
<br />SIGNATURE ~ ,REGISTERED
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<br />Address Iqa.~ 11\. !\Aeffr)C.o' Blud. Lo..~ b1rlI
<br />~~~EA~URE I I
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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 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.
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<br />COMPANY
<br />REGISTERED
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<br />Y / N I
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<br />FEE CURRENT
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<br />I Y /N I
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />I Y / N I
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<br />FEE CURRENT
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<br />License #
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<br />I Y /N I
<br />License # Is-s~(o )~
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<br />I Y /N I
<br />License # ml -('yy'y) 'A4J
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<br />FEE CURRENT
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<br />bCO)T
<br />I Y/N!
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<br />I Y / N I
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<br />FEE CURRENT
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<br />I Y / N I
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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 />SIGN PERMIT
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<br />Di~~~t;~~~':' , , , , , , , , , , , , , , , , , , , , , , . . , , , , , , . . , , , . . , . , , , , , , , , . . , , , , . . , , , . . , . , , , , . , , , , . . , , , , . ',,' , " . , , . , , , , , , , , , . . , , , , , , , , , . , , . , , , , , , , , , , , , , , , , , , , , , , , .
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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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