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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />
<br />
<br />/ Owner's Name
<br />
<br />/'Owner'sAddress Isc;?-,s
<br />Fee Simple Titleholder Namel
<br />
<br />\~ ~-\'(E:E' t 7-e~r\...u..\ \:::./
<br />I
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />15~3.~
<br />I
<br />
<br />~ 'So ~ ~~';\i. ecl
<br />
<br />LOT #
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />
<br />TYPE OF CONSTRUCTION D
<br />
<br />./ DESCRIPTION OF WORK '-1 ~'--':O... ~ c~ ~l^\\.4- ~c\.~,"()..( ~~_
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I
<br />TlllllllllllTllllllllllllllllllllllllllllll' 11111' 1111111' 1'111111"1 '1111' 1'11111' '1'11111111111111111'1 I1I1111I11111111111111 '11111' 'I 1 I11111111
<br />
<br />~\\,\,,~\\~
<br />I PARCEL ID#I
<br />E3
<br />D
<br />D
<br />
<br />/ JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />\=~L S$~L
<br />
<br />t \- ;llt;:1 -d, \ - 00'0 - 04<.:0::> - 60\ 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />D BUILDING / 1$ ~\C:C::J. C:() I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<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 ONO
<br />
<br />11111111111111111111111111111I111111111111111111111111111111111111111I1111111111I111111111111111111111111111111111I1111111111111111111111111111111
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />/ :~~~~~RE~~~ ~
<br />
<br />/
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />.~~fJ (l-~-Q.S
<br />Y / N FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />1111111111111111111111111111I111111111I11111111111111111111111111I111111111111111111111111111111111111111I11111I111111111111111I111111111111I11111
<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 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 onsile, 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />""PROPERTY SURVEY required for all NEW construction.
<br />
<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)
<br />
<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)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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