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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 />
<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
<br />
<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />: 70101/ rn:tly kdJ.
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<br />LOT #
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<br />SUBDIVISION
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<br />PARCEL 10#1
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK /--0{? VY"I G
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />, I I I I ' I I I I I I I I I I , I I I I I I I I f I I I I I I I I , I I I , , , I I I I ' I I I I I r I I I I I I I I r ~ I I I I I I I I . I I I I I I , ' I I I I , I I I I I I I I , I , I I I I I I . , I I I I ' , I , I I I I I I I ' , , I , I I I I ' , I I I I I I I I I I I , I I I I I
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />:2""'/ ~
<br />:-)~ -Cl'J-;)I-OO/o-//J3on-fJOJD
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE 00
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />I$~d 00 a7
<br />
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111I1I111111111111111111111111111111111
<br />
<br />COMPANY 14~~ e;;A:?M,qct--~~ (~4<JJ';"~~'l ~'CJt::!. I
<br />REGISTERED t Y I N I FEE CU _ Y I N--.J
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<br />License # I I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<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 />~::;~~~~RE ~E ~ 2c.cLL/
<br />
<br />Address l10'od D4k.CL)On,..O LJd,'v5_
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address License #
<br />1I11111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 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 on site, Construction Plans, Stormwater Plans wI 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 />SIGN PERMIT
<br />
<br />Dl~~~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 />Driveways-Not over Counter if on public roadways..needs ROW
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