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<br />Owner's Name
<br />
<br />Owner's Address I 4 ~ 5 ~
<br />Fee Simple Titleholder Namef
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />
<br />City of Zephyrhills Permit Application .
<br />Building Department ~ t./l&
<br />
<br />Fax-813-780-0021
<br />
<br />813-780-0020
<br />
<br />Date Received
<br />
<br />uJO(&-1
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />11 'beel- I LOT' I
<br />
<br />PARCELID#IJ5- ~U;~ct')-OCYYX)- O'3,;::;z)
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />SUBDIVISION
<br />
<br />LYQ5 Q
<br />I
<br />
<br />JOB ADDRESS
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />QZf MECHANICAL
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$ d I (2:l5t~.. DO
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I 1 FLOOD ZONE AREA DYES DNO
<br />
<br />11I111111111111111111111111111111111111111111111111111111II111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY D W.R.E.C.
<br />11/ .E',E'o ~D li'i.' l?Ei5'..cEE-
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address ! .
<br />
<br />
<br />~1~~':.~~~:LI~~-<'~4J ftP75iP
<br />
<br />Address q4blJ La L-.a()e 1>7-Y;;;
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I~
<br />Y I N I
<br />
<br />6~1,~
<br />FEE CURRENT I Y I N I
<br />
<br />
<br />
<br />License # Ie F"" C j '-I Qt)eo'3 7
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License #
<br />111111111111I1111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111
<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 />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
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloI/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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