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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 ~eceived
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<br />rz I Co-D"
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Owner's Name :.. E- Q.. P, L.\) V t\ JV !l'0 'i:-..."';.ij.'.j
<br />Owner's Address i 3 <6 tOO C AM D E u t\ "C
<br />Fee Simple TitleholderNamel rJ \ (:\
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<br />Fee Simple Titleholder Address I rJ \ A
<br />13~ roO CA~')E.u /ivE-
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<br />I ufh..., (\.... \ \5 Dol tJ, (O'-1e<....i
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<br />LOT #
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />PARCEL ID#I--S ~
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<br />.;o-C)\ 0010 ot-5500 DO ID
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0 DEMOLISH
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />B
<br />o
<br />~
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />83
<br />D
<br />D
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />
<br />WORK PROPOSED
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />DESCRIPTION OF WORK DCV' ~ S I Z-C ~ r S I Z_L
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<br />BUILDING SIZE I I SQ FOOTAGE I
<br />I I I I I I , I I I I I I I I I I 1 , I I I I I I I I I I I I I , I I I I I 1 I I I I I I I I I , , I I ~ I I I . I I , I 111 I , , I I , . I , , I I I ~ I I , I I I . I I . I I . I I , I I 1 , I I r I I I I I I , , I , , I I I I I , I I 1 I I , I I , I II,' I I t I 1 I I , I , I f I I I
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<br />
<br />[2] BUILDING 1$ \C) <61- ~~ VALUATION OF TOTAL CONSTRUCTION
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<br />D ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY D W.R.E.C,
<br /> (:JDe
<br />D PLUMBING 1$
<br />D MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES DNO
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE
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<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />I
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<br /> License #
<br /> FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />(
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<br />Address
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<br />
<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 />1111111IHtt,Uj,~11111111111111111111111111111111111111I11I111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111
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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 />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 />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />COMPANY
<br />REGISTERED
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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 />Dl~~~~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)
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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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