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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />F,,-a13-78I)-Oi- b <gcP
<br />
<br />Date Received
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<br />
<br />Phone Contact for Permitting
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<br />6wner Phone Number
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<br />~ Owner Phone Number I
<br />/7 '1r,~ 3 I
<br />.-' Owner Phone Number
<br />
<br />-Owner's Name
<br />
<br />- Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
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<br />Fee Simple Titleholder Address I
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<br />13QC)(' 7
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<br />PARCEL ID#
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<br />- JOB ADDRESS
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<br />SUBDIVISION
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<br />--WORK PROPOSED
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<br />SQ FOOTAGE I
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<br />('?V,,-Y
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />...... DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
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<br />TTfTTTI . I 11 I I I , , I I I I I I I . II I . I I , . I I I I I I , . I I , , I I I , I , I I , , I II . I II II I II I , I I , , II , I III , I I , I I I I II , I I , I , , I I I . 1111 , I I I , I , , I III I I , I II I I I . I I I I II I . I I , , I , . I I . I 1
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<br />D BUILDING 1$ I
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<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />
<br />- D MECHANICAL 1$ ,-~}S_~, 3>'6' I
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<br />D GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />1111I1111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />LOT #
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<br />D
<br />D
<br />D
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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 />OTHER
<br />STEEL
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<br />OTHER I
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<br />HEIGHT I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
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<br />AMP SERVICE
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />License #
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<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />License # I
<br />
<br />~;J} 141.1- ,Ai,~ EnJ.
<br />Y I N FEE CURRENT I Y I N I
<br />
<br />License # ~c, b l.f z 7? 7
<br />
<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address License #
<br />1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111I1111111111111111111111111111111111I111111
<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 wI 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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />""PROPERTY SURVEY required for all NEW construction.
<br />
<br />Dl~~~ti~~~': I . . I I I I . . I I I , , I . . , I I . I , I . I , . I I . . . . I I I . . . I I . . . , , . . I I I . . , , I . . . , I I I I , . , I I I . . , . . . . . . . . . . . , I I I . . . . . . , I . I I I I . . , . , I I I I . I . . . . . I . . I . . I , , . . , I . I I I
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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 A1C Fences (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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