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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Applic~on
<br />Building Department 6 r?
<br />
<br />Fax-813-780-0021
<br />
<br />112,;;(,22- ~~1jV
<br />
<br />Owner's Name
<br />
<br />
<br />Date Received
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />z, 2- -- ~M.
<br />7J&wner Phone N~r Ii!? 711f - (1' ~t()
<br />
<br />
<br />I Owner Phone Number I
<br />
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />PARCEL ID#
<br />
<br />WORK PROPOSED
<br />
<br />52r
<br />D
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN D MOVE D
<br />
<br />~THER Jl4( M y-;..1-
<br />D STEEL D OTHER I
<br />
<br />DEMOLISH
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~'~LECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<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 />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />ELECTRICIA
<br />SIGNATURE
<br />
<br />
<br />License # IRi ~ tfF~ ~1
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />11I11III111I111III11I1111I111111111111111111111111111111111111111111I1111111111111111111111111111111I1111111111111I1111111I11I1111111111111I1I1I11
<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 />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ii~~~': ' , , , . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . , . , , , , , , , . , , , , , , . . . , , , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , , , , , , . , , , , . . . , , , , , , . , . . , , , , . , , . . . . . . .
<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 A1C Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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