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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 />Fax-813-780-0021
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Date R~celved
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<br />Owner Phone Number
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<br />"ft: (0 r3 ,Owner Phone Number I
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<br />T2}1 y~r'-'" I
<br />Owner Phone Number
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<br />Owner's Name
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<br />SUBDIVISION
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<br />LOT #
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<br />Fee Simple Titleholder Address
<br />31 (A5
<br />JOB ADDRESS
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<br />WORK PROPOSED
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
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<br />DEMOLISH
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />D
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<br />DESCRIPTION OF WORK
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<br />BUILDING SIZE
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<br />I
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<br />111111111 . . I III11IIII , , 11111 . . 1111 . 1II1I n I . I 11111 , . 11111 , . 1111 .. II , " . 1111111111 ., 1111111111 . III , 111111111111111 I111111 , 1IIII111I11111 , I . 11II1111
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<br />: ~/UILDING
<br />ELECTRICAL
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<br />:: ZO~O . oJ{ :
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS 0 ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C,
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<br />~
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />BUILDER
<br />SIGNATURE
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<br />Y / N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />l I
<br />FEE CURRENT Y / N 't;4
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<br />License # 1bIf, (J p (I
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />MECHANICAL
<br />SIGNATURE
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<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />OTHER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address License #
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<br />11111111111111 1111I1111111111111111111111111111111111111111111111I111111I111111111111111111111111111111111111111111111111111111111111111111111111
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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 subdivisions/large 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 w/ 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.
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<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)
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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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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