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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-Q021
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<br />Da~e Receiv!!d
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<br />
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<br />Owne'. Add,ess I P (') ~'f-
<br />
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Cola \ (~\rflJ\(S~lt)a I
<br />
<br />9
<br />
<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 />JOB ADDRESS
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<br />1(~CPl ~ t\o('~?orS I
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<br />D NEW CONSTR D
<br />D INSTALL D
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
<br />DESCRIPTION OF WORK I ~e:,'\5.. \e. 'fb~ u; ~
<br />
<br />BUILDING SIZE ()?:; X 75lo I sa FOOTAGE ~ _ r..o HEIGHT I
<br />
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<br />1$ L1,oOO
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<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES ~o
<br />
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<br />
<br />~~:~~~~ I ~~111 i (~EE CURRENT ~ N I I
<br />License # IJ:'H -oCX 'J:) ~q 4J
<br />~~:~~~~ ~~ ff\ ~EE~R~~-e~~~(\( I
<br />License # It: s {)(X)CI\( () \ I
<br />COMPANY ~ I
<br />REGISTERED ~E CURRENT -~
<br />
<br />License # tKl+ -C(XX)714 I
<br />Ie
<br />N
<br />
<br />SUBDIVISION
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<br />WORK PROPOSED
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<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 D
<br />
<br />OTHER k'I'cL'): \-t>
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<br />I
<br />~I
<br />I
<br />
<br />D
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D
<br />
<br />ELECTRICAL
<br />
<br />560
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<br />AMP SERVICE
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<br />r$1
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />PLUMBING
<br />
<br />CoccD
<br />'750
<br />
<br />NOL.
<br />
<br />D
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<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMMERCIAL
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<br />::::~~RE I ~ ~ I
<br />Address I~~flc\. 2-ltlls 3?)SL/oI
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<br />ELECTRICIAN I (. Jj - ""'^' ~ ~ _h.. l I
<br />SIGNATURE . ~ ~~ .
<br />Address Ro;B lU m-e ,mOilCLl 13 II lcl. l G.. ~ 6iili
<br />
<br />~~::r~~E I ~ ~ I
<br />Address 1'3l\~~CC.rtalnA.t uZcL 7-' ~ \ ~ 5~SI([)
<br />:,~:'~~:;:LI ~ ~ I
<br />Address q ~~ V) mem6n{1\~. I~QOLB
<br />~~~:TURE I I
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<br />
<br />Address I License #
<br />1111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111I111111111111111I11111111111111111111111111111
<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 />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />FEE CURRENT
<br />
<br />SIGN PERMIT
<br />
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<br />Directions: .
<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 A1C Fences (Plot/Survey/Footage)
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