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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Owner Phone Number
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<br />Owner Phone Number
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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 I f/tJ iJr/htJa "I ~ 2tXJ
<br />Fee Simple Titleholder Namel
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<br />- 1~"<I- 35/11
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<br />Fee Simple Titleholder Address
<br />JOB ADDRESS 5'3/~ /1 tt Sin ~f
<br />SUBDIVISION I
<br />WORK PROPOSED B NEW CONSTR B
<br /> INSTALL
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
<br />DESCRIPTION OF WORK
<br />BUILDING SIZE
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<br />LOT #
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<br />PARCEL 10# I
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />HEIGHT I
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<br />BUILDING
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<br />D PLUMBING 1$
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<br />D MECHANICAL 1$
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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 />ELECTRICAL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE D ~
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y / N
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<br />FEE CURRENT
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<br />Address
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<br />License #
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<br />COMPANY I 41/1~ E/c-c/rrc
<br />REGISTERED Y / N I FEE CURRENT I Y / N I
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<br />,.A/ils FI 33S""'1P License # I EC -~OO f2-t,J
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/ N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />COMMERCIAL
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
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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, 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 wI 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.
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<br />License #
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />SIGN PERMIT
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<br />DI~~~ii~~~': . , , , . . . . . . . . . , , . , , , . . , . , . . . . , . . . . . , . . . . , , , . . , . . . . , , . . . , . . . . , , , . . , . . , , . . . , , , . . , , , . . ~ . , , . , . . , . , , , , , , , . . . . , , , , , , , . . , , . , , , , , , , , , , , . , , , , , , , .
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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. (Ale 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 A1C Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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