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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />~C-
<br />b~LL- ;Ji-I/O
<br />
<br />
<br />Fax-813-780-0021
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<br />~ ~11~
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<br />Date Received
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<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
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<br />Owner's Name
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<br />Fee Simple Titleholder Address I
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<br />5303
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<br />I LOT# I
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<br />I PARCELlD#1 //~X"~I -O(JIO ~/3:2()O- D,JYO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR D ADD/ALT D SIGN 0 MOVE D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL 0 OTHER I
<br />
<br />DESCRIPTION OF WORK I ~4.y C'~ sA, /]7/~f Fe -/tJz,/ ~~ H 3tJ't'''' c!t"'e'r?5ICfnQ,/'
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I I .s 4- - ://-eS
<br />TTTTTTIIIII , ' 11111111111111111111 , 1111111111111111111 , III ' 11111111 , 111111111111111 f 1111111 , I ' 11111 , III , 1111111111111 ' 1111111 , ' 11111111111 . 1111111 ,
<br />
<br />0-t4r
<br />
<br />Sf/" ~,,&+
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<br />JOB ADDRESS
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<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />D
<br />
<br />D
<br />D
<br />D
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ 1
<br />
<br />D GAS ~ ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<br />ELECTRICAL
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PLUMBING
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<br />MECHANICAL
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
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<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 /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />OTHER
<br />SIGNATURE
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<br />
<br />License #
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<br />I Q'tOV93'7cJ
<br />
<br />Address
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<br />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 wI 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 />DI~~~ii~~~': ' , , . , , , , , , , , , . , , , , , , , , . , , , , , , , , , , , , , , , , , . . , , , . , , , , . , , , , . , , , . . . , , , , , . , , , , . . , , , , , , , , . . , , , , , , . . . . . , , , , , , , , , , . , , . , , , . , , , , . , , , , , , , , , , , , , , , . ,
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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. (A1C 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 />RESIDENTIAL
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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