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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
<br />
<br />
<br />
<br />~'J.rc'e_ U-"; Y'"Y" Owner Phone Number
<br />
<br />\-' .(). be.>.. llv't 71 -:fff I
<br /><;'(0 l'...? . ZU-ilk c;L 335 OlNner Phone Number
<br />
<br />
<br />I Owner Phone Number I
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<br />Owner's Name
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<br />Owner's Address DL.'C\ N ?..:l ICo k. ~
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />('(.-\0S~:> .ku-nl"\u",u )
<br />
<br />PARCELlD#1 \ \ -7..l.o -2.1- 0010- 'Co 700 . b(Ji 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />LOT #
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<br />JOB ADDRESS
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<br />3<644 Y
<br />
<br />8-n ~0
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<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />B
<br />D
<br />D
<br />h~~1
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
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<br />1$ ;;).60D, 0-0 I
<br />
<br />o ELECTRICAL 1$ I
<br />
<br />o PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
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<br />
<br />o
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY c=J
<br />r-: I VY'l - <611 Ld:,)'{
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />Address
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<br />139.0 Ll
<br />I
<br />1
<br />
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<br />c.. '1' ,
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />~~I ~~#
<br />1111111111111111111I111111111111111111111111111111II111111111I111111111111I11111111111111111111I11111111111111I1111111111I111111111111111111111111
<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 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 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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Di~~~ti~~~': . , . , , , , . . , , , , . , , , , . , , , . . , , , , . . , . , , , . . , , , . . , . , . . . . , . . . . . . . . . , , , , . . , , , . . , , , . , . . . , . . . . , , , . . . . . . . . . . . . , , . . , . . . . . , , , . . , . . . . . . , , , , , , , . , . , . . . ,
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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)
<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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