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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 />Owner's Name I.
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<br />Owner's Address I t-{a '-1-2 I C II ~~ c E Y I? .])
<br />Fee Simple Titleholder Namel
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<br />D ADD/ALT D
<br />D REPAIR
<br />D COMM D
<br />D FRAME D
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<br />BUILDING SIZE SQ FOOTAGE L\~5 0 I HEIGHT I
<br />1111111'1111"'11""'1"111111111111111111111111111111111111111"'11'1'11'11'1111111111111111'111"11111111111111111111'1111111111111111111'11111
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<br />Date Received
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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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 />L( ('4 IS &-
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<br />LOT #
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<br />C {/ A I'-t. C r-
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<br />PARCELlD# \<6~Llo -22 . DO 0- 1~<6r _0000
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />OTHER
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<br />OTHER I
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<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />
<br />0 BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
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<br />D
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<br />W.R.E.C.
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<br />PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
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<br />
<br />
<br />BUILDER
<br />SIGNATURE
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
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<br />Y / N FEE CURRENT Y / N
<br />License # I c~ /..25"21<9
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<br />Y / N I FEE CURRENT Y / N I
<br />License # lEt::" --ocC>..<?78
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<br />COMPANY
<br />REGISTERED
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<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
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<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 />111I111111I1111111111111111111I11111111111I111111111111111111111111I111111111111111111111111111111111111111111111111I1I111111111111111111I11111111
<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 subdivisionsllarge 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 />COMMERCIAL
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<br />SIGN PERMIT
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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)
<br />
<br />.. Agent (for the contractor) or Power of Attorney ,Cfor 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 (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadwaysOoneeds ROW
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