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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 />Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />c..r (' r ri\CA n (\
<br />Fec;tbe(;".'ll' h'?3"i'~~i
<br />1
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<br />Owner Phone Number ~13-' ~ql-,;;) 7 ~CJ
<br />Owner Phone Number I fl3 ~ 3 gg - IJ L/<l
<br />Owner Phone Number I
<br />
<br />Date Received
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<br />Owner's Name
<br />
<br />JOB ADDRESS
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<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />~
<br />D
<br />D
<br />\e,f\ce- in +'~
<br />
<br />sa FOOTAGE I
<br />
<br />2- '\\ -L. 3'~ LOT# L\S
<br />PARCELID#lL:i, ~1..r?-JI-0Iq.O-OroDO"'DI50
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />MOVE D
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />
<br />D OTHER
<br />D STEEL 0
<br />o..b\- ~)S'~
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<br />I
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<br />SIGN
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<br />o
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<br />DEMOLISH
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<br />f~l\cC
<br />OTHER I
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<br />DESCRIPTION OF WORK
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<br />TTTlTTTT"TTTII , , III1IIII1 II , II , . I , , III . III , . II , I III , III n I 111111' I , . 1III , , . II , II1I , II . 1111111111111 , II1III . III , 111 , II r II , III r 11 r IIIIII , II , IIIIIIIIII
<br />
<br />BUILDING SIZE
<br />
<br />HEIGHT I
<br />
<br />D
<br />
<br />1$
<br />
<br />1$
<br />
<br />o PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111
<br />
<br />::::~~~~RE I ~ ~ ;.':':R: I ~;,ro~~.c VIN
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<br />
<br />Address I License # I
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o
<br />
<br />BUILDING
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />ELECTRICIAN I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License #
<br />1111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111I11111111111111111I1111111111111111
<br />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 onsile, 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 />Di~~~ti~~~':' . . , , , . . . , , , . , , , . . , . . . . , , , . . , , , , . , . . , . . . . . . , . . , . . . . , , , . . , , , . . . . . , , , . . , , , . . . , , . . . , , '. . . . . , , . , , , . . . . . , . . . . , , , , , , , . . . , , , , , , , , , , , , , , , , , , . . , .
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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