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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 />Date Received
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<br />ftiJe..
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<br />Owner Phone Number ~ ~I.
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<br />Owner Phone Number Id..ell,j'
<br />Owner Phone Number I
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<br />/' Owner's Name 05:
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<br />./ Owner's Address \3CjO;J3
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />\390&3 (In()CtI'1 () de.
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />2ef11'j f-h ,lIs I Fl. a 6 Sq;;... I LOT# I
<br />PARCELlD#U3- )(P-z{- Dr }...o-()()O(f) -631tJ
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN D MOVE D
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />/ DESCRIPTION OF WORK , e.
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<br />,/ BUILDING SIZE. I . SQ FOOTA!E I I HEIGHT ()
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<br />1$ hk~ltS/?() I
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<br />o ELECTRICAL 1$ I
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<br />o PLUMBING 1$ I
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<br />o MECHANICAL 1$ I
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<br />o GAS D ROOFING D SPECIALTY D OTHER
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<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />BUILDER ! ,,-4/./.4 C./ / 62t~D COMPANY Gbue ~
<br />/ SIGNATUREI;7'l~,<, 2O/d?'a I ",e'''''''" '-'4:' Y I N I FE' CURREN'
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<br />Address . License # I
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<br />ELECTRICIAN I COMPANY
<br />SIGNATURE REGISTERED Y / N FEE CURRENT
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<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />Address I
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<br />MECHANICAL I
<br />SIGNATURE
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<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 onsile, 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 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 />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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<br />/0
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Y/N
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<br />Y/N
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<br />License #
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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 />Y/N
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<br />License #
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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 />Y/N
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<br />License #
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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 />Y/N
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<br />COMMERCIAL
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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. (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 (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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