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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 />~(p 1<t1
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<br />Date ReC'l!ived
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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
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<br />Owner's Address
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<br />Fee Simple Titleholder Name
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<br />Fee Simple Titleholder Address
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<br />_ JOB ADDRESS
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<br />LOT #
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<br />WORK PROPOSED E3
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<br />PROPOSED USE B
<br />TYPE OF CONSTRUCTION D
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<br />DESCRIPTION OF WORK 1;( l. Ii (J" f
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<br />BUILDING SIZE I SQ FOOTAGE I ") J lJ HEIGHT I
<br />I,IPIII'..'IIIIIIIIII'IIIIIII"IIII'.IIIIIIIII"IIIII,1111,1'11111"11'.."11111111111111'1111'.'."111'11111'1"111111"'111111'111111'1111111111
<br />1$ S~3 S' I
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 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 />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I11111111111111111111I111111111111111111I111111111111I11111I11111111111111I111111111111111
<br />
<br />NEW CONSTR
<br />INSTALL
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<br />SFR
<br />BLOCK
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<br />B
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<br />PARCELlD#I,I-Jt -.21- 0610 -/1 ~() - tJo.~()
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
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<br />SUBDIVISION
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER I R ~ KPIP r
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<br />BUILDING
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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 />WR.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />FEE CURRENT
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<br />tJJ;v1 -f)-LA Kt5.s
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<br />License #
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<br />I (lc,.C 13;.7 3.r'l
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE ,
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<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
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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 />Address
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<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address License #
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<br />I111111111111I11111111I1111111111111111111111111111111I11111111I111111I111111I11111111111I111111111111I1111111111I11111111111111111111111111111111
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<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
<br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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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. (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 />Driveways-Not over Counter if on public roadways..needs ROW
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