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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />ill
<br />138fJ():J fU11ft1l1 ~ W;f'-(
<br />
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
<br />
<br />lowner's Name
<br />
<br />I 'Owner.s Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />~~~
<br />
<br />'"
<br />/ JOB ADDRESS
<br />
<br />J&
<br />
<br />IE 60-C
<br />I
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCELID#114~ ~~ .;;)\ - 0\10.00000.- 0/4-0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />D
<br />D
<br />I L-An-ai
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />OTHER
<br />STEEL
<br />
<br />;. DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE sa FOO~GE II \ X.5 U HEIGHT I
<br />
<br />0"" '~~,':~;~~"""" 'u;;;' '2;f :$i~~ ;~~~~'~~~~~~~~~~""""""'" ..""""""""",','" ,
<br />
<br />o ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W.R.E.C,
<br />
<br />o PLUMBING 1$ I
<br />o MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
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<br />COMPANY I J~ttl[ 610 !Jt1Z
<br />REGISTERED I / N I FEE CURRENT Y/N
<br />/ License # I
<br />/ I
<br />COMPANY
<br />REGISTERED Y / N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y/ N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED Y / N FEE CURRENT Y/N
<br />
<br />
<br />Addre..,
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />
<br />111111111I11111111111111111111I11I11111111I11111111II11111111111I11111111111111I1111111I11111111I11111I1I11111111111111111I1111111
<br />
<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 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.
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ii~~~':' , , , , , , , . . , . . , , , , , , , . . . , . , , , , , . , , , , , , , , . . , . , , , , . . , . , . , , I I , . . , , , , , , , , , , , , , , , , , , , , . , . , , , , , , , , , , , , , , , . . , I , . , , . , . , , . . , , , I I , , , , , , , , , , , , , , , , ,
<br />
<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 (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTeR PERMITTING (Front of Application Only)
<br />Reroofs Sewers ServiCe Upgrades AlC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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