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<br />813-780-0020
<br />
<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 />
<br />
<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 A. R.. c:;. \-fa.n~
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<br />Owner's Address I P,cO . ~ D~\ l.::,~\
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<br />Fee Simple Titleholder Namel
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<br />Foe Simple TllIeholde, Add",.. ~
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<br />JOB ADDRESS IloS ~ ~
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<br />'S.tu.J, v vy"\
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<br />PROPOSED USE D
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<br />TYPE OF CONSTRUCTION D
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<br />DESCRIPTION OF WORK I fC~~\...t..Q.. IOOA Mc..:v.. ~;~~14"'&l..t
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<br />BUILDING SIZE I I sa FOOTAGE I I HEIGHT
<br />TTTTTfI 1I1111 ' I111 , ' . II P , ' I , , ' III ' , 1111I , 1111I , 11111 ' 1I11111I , ' III11111 , . 1111I ' III ' I I ' 111I1111 , ' III ' III1I , , ' III , ' , , , III , 1111 ' 1III1111 , ' I1I1111111 ,
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />~~~I(~'\ln. {7,-, 3~{tMOT#
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<br />PARCELlD#1 D~ ~~~-'~ ~. ODt p.::> - Oo:t:'..:;o.- Oc'~a
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />D BUILDING
<br />~ ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />1$ I
<br />1$ ~3 -',0 a I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111II111111111I111111I11111I1111111111111111I11111II11111111I1I11111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />csm
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<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
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<br />License #
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<br />ELECTRICIA",I--rfl"- ~ ./\1
<br />SIGNATURE ~ ,~ .
<br />Address ~ -0. ~ ~~J h:\!s H. ~ I
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<br />COMPANY
<br />REGISTERED
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<br />l'Re.LS-e- tle.e..:tll' ~\.. ~<--
<br />I~ N I FEE CURRENT N I
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<br />License # I al~ l~<;~
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<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
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />111I1111I11111111111111111111111111111111111111111I1111111I11111111111111111II1111111I11111111111111111111111111I11111111111111111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlsionsllarge 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 wI 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 />COMMERCIAL
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<br />SIGN PERMIT
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<br />Di~~~ti~~~': ' , , 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 NC Fences (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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