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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 />1-3/-117
<br />
<br />
<br />Owner's Name
<br />
<br />
<br />/'l?1IJA, Slree/ rur",lurt"
<br />3 Y .J:l.5"' S'/Il 2~ ...~/~
<br />
<br />"c/.
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />
<br />SUBDIVISION
<br />
<br />,':JF ~~ ~- 5""" !NfU 2 e f..,...h//Ir PI.
<br />
<br />I PARCELlD#1
<br />
<br />D NEW CONSTR D ADD/ALTO
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />::z.vs/"// 3 E~;J.,L, Jh :IN $/"/1
<br />
<br />BUILDING SIZE I I sa FOOTAGE HEIGHT I
<br />11111111'1111111111"1111'1111'11111'1111"'111111111111111111'111111111111111'1111'111'1111'1111'11111111111I1111111111111111111111I1111111111111
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />
<br />D BUILDING 1$ I
<br />
<br />W ELECTRICAL I~.>t;.~ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111
<br />I
<br />I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />FEE CURRENT
<br />
<br />
<br />Address
<br />
<br />License #
<br />
<br />Y/N
<br />Ic~ -~(l/-'t,
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<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 />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
<br />
<br />License #
<br />
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 on site, 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 />jji~~~tj~~~': ' , , , . , , . , , . , , , , . , . . . , , . . , , . , , , , . . , , . . , . , , , . . , , , , . , , . . , , , . , , , . , , , , , , , , , . , , , . . . , , . , , , , , , , , , , , . . , , , . . , , , . . . , , , , . , , , , , , . . . , , , . , , , , , , . . , , , , ,
<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 NC Fences (PloUSurvey/Footage)
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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