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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 />Fax-813-780-0021
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<br />Date Received
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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 cJ
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<br />Owner's Address 1'30; '32 C;J OrCt~ #'7'f-v~
<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />JOB ADDRESS .3 'Y 3 2- / 0 rc, /;tY
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<br />ff-ve
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<br />LOT #
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<br />D NEW CONSTR Cl
<br />D INSTALL D
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
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<br />DESCRIPTION OF WORK I /2e "......)c,,).f v-J/ ~ 2- S- /kC-t. v
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<br />PARCEL ID#I
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />12-L~ - 2 \ _ ooL\-o - 00200- 0 \ \ 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />COMMERCIAL
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<br />License # I
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<br />OTHER J bl ~ ~ /' COMPANY I;:" frqJ ("-. L k~ It cx.! <f( ~
<br />SIGNATURE _~c::7Y REGISTERED I Y / N I FEE CURRENT I Y / N
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<br />Address I '3 JOt u 5 e e;-"Z- License # I C' c ,--oT7iS7
<br />111111111111111111111111111111111111111111111111111111I1111111111111111111111I1111111111111111I11111111I11111111111111I1111111111111111111111I1111
<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, Storm water 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 />1$ :?/-( L(Or Do I
<br />1$ I
<br />1$ I
<br />1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11I11111I11111111I11111111I11111111111111111I11111111111111111111111111111111111111111111111I1111111111111111111I111111111111111111111111111111111
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<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E,C,
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<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 />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 />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 />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 />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)
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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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