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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
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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 S - {I
<br />Owner's Address 11-/ () 4 -? I C 1-/ tA.H C t;:y 12 b
<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS
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<br />404(5 &,(J~ ....7 CHt7}'--\cf-
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<br />LOT #
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<br />DESCRIPTION OF WORK
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<br />ADD/ALT
<br />REPAIR
<br />COMM
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
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<br />BLOCK
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<br />PARCEL 10# \~ -?J..o .:z..:7- . (j:)\O "0'6 0.- 000'0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SUBDIVISION
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<br />FRAME
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<br />HEIGHT
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 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 />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 />BUILDER
<br />SIGNATURE
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<br />COMPANY
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<br />License # I?FC o~w7~1
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<br />License # IC/.5C/25"...<I.2ct
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<br />I Y / N I FEE CURRENT Y / N
<br />License # I p;c- Oc>O,<57o
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<br />PLUMBER
<br />SIGNATURE
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<br />
<br />ELECTRICIA
<br />SIGNATURE
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<br />Address
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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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsions/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.
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<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 />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 (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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