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<br />Owner's Name
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />813-780-0020
<br />
<br />\t:~' .
<br />
<br />Date Received
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number L
<br />
<br />Owner Phone Number C
<br />
<br />Fee Simple Titleholder Address I
<br />
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<br />
<br />JOB ADDRESS
<br />
<br />LOT #
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />IlkId'-(J 11 (P
<br />
<br />I SQ FOOTAGE I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCEL ID# I \\ - 3 G . d., - CO \ 0 " I y.:~O{) - 0 c->o 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />ADDIAL T
<br />REPAIR
<br />COMM
<br />
<br />FRAME
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<br />D
<br />D OTHER
<br />D STEEL D OTHER I I
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<br />r I HEIGHT I - I
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<br />DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
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<br />
<br />D
<br />
<br />1$ 18crLf~ ~ I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
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<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />~1\f\ - ~-+ 5/:2:3h7
<br />~~OL - ,0/ p..,
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> License # [
<br />YIN FEE CURRENT
<br /> License # [
<br />Y I N FEE CURRENT
<br /> License # [
<br />YIN FEE CURRENT
<br />
<br />YIN
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License # r
<br />
<br />I//f )! ~l,(ePI>:({)p
<br />YIN
<br />
<br />Address
<br />
<br />~~ I
<br />
<br />
<br />37IJO ffe~l:7>~ 1Jftl, YeP, :3 '3(P 0' r I License # L
<br />
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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 onsile, Construction Plans, Stormwater 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 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 />
<br />FEE CURRENT
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
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<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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter If on public roadways..needs ROW
<br />
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