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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />
<br />S-flt Aye
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
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<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address I '3~o 39
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />JOB ADDRESS I 3~O39 ~flt Ave
<br />SUBDIVISION I I
<br />WORK PROPOSED B NEW CONSTR B
<br /> INSTALL
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
<br />
<br />lOT #
<br />
<br />PARCELlD#IIl-~-Z.I-OO'O- 1'5""00- 00 ~O
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL 0
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK RenovlA..-j,. it \l'-'.. \'ldcv.:.s ~,ch.-\ 2 c;
<br />
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT
<br />,III"'I',I,III".II",II"III"I'I"III,,'.III,,,'P'P'111"'11"'11""'111"111"'11"'11"'1"'1"""'""'111111'11111'1""""""'1'111111
<br />
<br />
<br />~ BUILDING
<br />GZJ ELECTRICAL
<br />[Z] PLUMBING
<br />D MECHANICAL
<br />
<br />I /3' () - - I 1 VALUATION OF TOTAL CONSTRUCTION
<br />$ &. 00 W""60 S
<br />1$ .,.. DO · J L AL-r I, AMP SERVICE
<br />. 7 ~ - fV~W 1 v-'" I^ ffDYI-f-
<br />I$IJt~ll f.;.;S:~s 4/3't~/' Brl"~lL"'6C__
<br />
<br />1$
<br />
<br />DGAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />ROOFING
<br />
<br />1
<br />D
<br />I
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />DYES
<br />
<br />DNO
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY f!)#vIU$~
<br />REGISTERED I Y/ N I FEE CURRENT
<br /> License #
<br />'1 ') " I 'W,J~ 12.
<br /> I Y/ N FEE CURRENT
<br /> License #
<br /> IbWNSt!.
<br /> I Y / N FEE CURRENT
<br /> License #
<br />COMPANY I 0 IJII #Jf,Jl-
<br />REGISTERED I Y / N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Y/N
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />COMMERCIAL
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<br />Address
<br />
<br />MECHANICAL! A II;.
<br />SIGNATURE IV;f-t
<br />,
<br />(
<br />Address
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />111I1111111111111I111111111111111111111111111111111111111I11111I11111111111111111I1111111111111111111111111111111I1111111111I11I111111111111111111
<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.
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
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<br />Di~~~ti~~~': . , . , , , , . . , , , . , , , , . , , , , , . . , . , , . . , . , , . , . . , , , . . , . , . . , , , , . . , , , . . . . , , , . , , , . , , , . . , , , , , . , , , . , . . , , , , , , , , , , , , . . . . . , , , , , , . , , , . , . , . . . , , . , . . , , , , , , ,
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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)
<br />
<br />.. Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plol/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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