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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 />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />1':37606
<br />I
<br />
<br />;f(/{c-,)~ Y Ave-
<br />/ I
<br />
<br />lOT #
<br />
<br />E3
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I 1:6 - 12. f} ()~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />"'11111111'1111'1"1111'111111'11111'1111"11'1111'11'111"1"11"1'11'11'11'11111"111111"1'111"1'1'111111111111'1'111111111111111111'11111111
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PARCELlD#ll'3'~Co -;;< \ - D\bO - 00D00 - 0 9--~O
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />D ADD/ALT
<br />~REPAIR
<br />D COMM
<br />D FRAME
<br />
<br />/7?
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />~ BUILDING '$1:
<br />
<br />L---J ELECTRICAL I .
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS ua-- ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1111111111111I1111111111111111111111111111111111111111I1111I11111111111111111111111111111111111I11111111II1111111II1111111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />'" L( CO t' J
<br />) ,
<br />/
<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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<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 />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 />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY ~ ~ t// ~ ~O~/ /J({~
<br />
<br />REGISTERED (: N I FEE CURRENT I ~ I N I
<br />
<br />f D /J 0 'I I J t?-1 /JJ~: / -:J .7.)~ License # I;C' C (' (I f 6"2 ill
<br />
<br />11I111111111111111111111111111111111111111111111111111111111111111111111I11111111111I11111111111111111111111111111111II11I11111I11
<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 wI 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 onsile, Construction Plans, Stormwater Plans wI Sill 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 />~).
<br />/t (''-~~
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />/11111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ij~~~': ' , , , , , , , , , . , , . , . , , , , , , , . . , , . . , . , , , , , , , , , , , , . , . , . . . . . , , , , . , . , , , , , . , , , , , , , . , . , . , , . , , . , . , . , , , , , , , . , , . . , , , , . . . . . , , , , . , , . , , . , , , . , . , , , , , , , , , ,
<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 (PlotlSurvey/Footag~~
<br />
<br />Driveways-Not over Counter if on public roadways 00 needs ROW
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