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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Applicatior~
<br />Building Department
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<br />t-aX-!llj-(~U-UU" I
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<br />4 ~ ((p ~ () ...,
<br />Date Received ~ 7
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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 />I PARCELlD#G""2... 'Z4:>-z.....\ C;OOo e>4q 0 L")
<br />(OBTAINED FROM PROPERTY TAX NOnCE)
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<br />I2f ADD/ALT D SIGN 0 MOVE D
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<br />D COMM D
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<br />D FRAME D
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<br />LOT #
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I f./( ( ~
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />B
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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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 D
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<br />OTHER I
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<br />SQ FOOTAGE I
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<br />HEIGHT I
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<br />I \-\,1 ~(l ~'-> \Ofr~~ ~~\L.
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<br />BUILDING SIZE I ft -) J') 0 c)o :s.( I
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<br />1$ C10 K
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<br />1$ 10 K.
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<br />1$ .1=\ {<..
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<br />1$ "l-- K
<br />D GAS ~ ROOFING
<br />FINISHED FLOOR ELEVATIONS I
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<br />DESCRIPTION OF WORK
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<br />BUILDING
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<br />AMP SERVICE D PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION ~{ ~i VY\ ~
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />ELECTRICAL
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<br />PLUMBING
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<br />MECHANICAL
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />License #
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<br />BUILDER -rr .--/
<br />SIGNA lURE I \ ~
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />~LECTRICIAN
<br />. SIGNATURE
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<br />~LUMBER
<br />SIGNATURE
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<br />Address L. ~
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<br />COMPANY
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<br />License #
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<br />OTHER
<br />SIGNATURE
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<br />
<br />
<br />Address License # I
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<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-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.
<br />
<br />
<br />~ECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />
<br />License #
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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 />COMMERCIAL
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<br />SIGN PERMIT
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<br />DI~~~ij~~~':" . . . , , . . , , . . . . . . , , . . . , . . . . . . . . . . , . , , , . . . , , , . . . . . . . . . . . , , . . . . , ., . . , . . . . , ,., . . . .. ',' 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. (Ale upgrades over $5000)
<br />
<br />.. Agent (for the contractor) or Power of Attomey (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 (Pial/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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<br />CITY,QF ZEPHYRdiLLS
<br />(6Lc'd 1/20/07
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