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<br />813-780-0020
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />if' Owner's Name
<br />
<br />; Owner's Address
<br />
<br />Fee Simple Titleholder Address
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />B
<br />D
<br />D
<br />5>//0
<br />
<br />1~/;~~" -21-0lM _6~60l:T;()~o
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN D MOVE D
<br />
<br />D
<br />D
<br />
<br />/JOB ADDRESS
<br />
<br />2//. ~ ') '~'~-
<br />o O.?\, ',../. 'LU~
<br />
<br />SUBDIVISION
<br />
<br />~
<br />
<br />PROPOSED USE L.1iJ
<br />TYPE OF CONSTRUCTION D
<br />
<br />.-DESCRIPTION OF WORK I ~~~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />1111111111111111111111111111111111111111111-"111111111111111111111111111111'1""'111111111111111111111111111111I111I1111111111111111111111111111
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />s~.e.A.
<br />OTHER I
<br />
<br />[Z]
<br />
<br />/1$ 1.717,ds' I
<br />
<br />,
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
<br />
<br />1111111II11111111111I1111111111111I111111111I111111111IIIIIIIIIIIIIIIIIIIIIII~~IIIIIIIIIIIIIIIIIIIIIIIIIIIII111111I1111111111111111111111111111
<br />~ I &:I0, I / I
<br />BUILDER ,-p .e " -=-, COMPANY" h~ tPLd-Jv.-AJ
<br />, SIGNATURE '-/ ~ 1/ d, /.>> ~ REGISTERED " '1 Y / N I FEE CURRENT Y / N
<br />
<br />Address I License # I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W,R.E,C,
<br />
<br />D
<br />
<br />PLUMBING
<br />
<br />D
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />1111111I111111111111111111111111II111111111111111111111I1111111111111111111111111111111I111111111111I11111111111111111111111111111
<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, Storm water Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Dl~~~ti~~~':' . , , . , . . , , . . . , , . . , . , . - . , , . , . . , , , . . - . . , , , . . , , , . . , , , . . , , , . . . . , , , , . . . , , , . . . . , , , . . , . , . . . . . , , , . . . . . , . . , , , , , , , , , . . . , . , , , , , , , , , , , , , , , , . . , . . . . .
<br />
<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 Attorney (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 (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadwaysuneeds ROW
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