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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 />WORK PROPOSED
<br />
<br />E3
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<br />IW\fe
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br /><3 (~- ';<8?5 - <-iL(83
<br /><B 10 IOd - Jfldo I
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<br />I LOT # I 3 I I
<br />I PARCELID#I ~l\ 'CX5~d) - c:xJ9o - cx:x:m- (JBlDI
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />C:=J ADD/AL T D SIGN 0 MOVE D
<br />Cl REPAIR
<br />D COMM D OTHER I ( .ro.u (P.(1+e1"
<br />D FRAME D STEEL 0 OTHER I
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<br />'\f\6\t:l,ll () EerCj. L16J/EXit Com~[2.)
<br />
<br />I SQ FOOTAGE I _ HEIGHT I I
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<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />
<br />Owner's Name C I <: 0: n
<br />Owner'sAddress I 'Jlo\...15 b\G::n SLo~ \Jr.
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />13D--C:O n80~(Y)
<br />IC1\r1fd'rtori20n3
<br />
<br />Nve
<br />
<br />SUBDIVISION
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />""'1111111"1111111""'11'1111111"'1111'1'1111'111111111'1111111111'111111111111111111111"11111111111111111111111111111111'111111111111111111
<br />
<br />1$ I
<br />1$(0\5 ,00 I
<br />1$ I
<br />1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I1111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111
<br />
<br />0 BUILDING
<br />Er ELECTRICAL
<br />0 PLUMBING
<br />0 MECHANICAL
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.RE.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
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<br />IAY~I :r\f~~~t7cn/~0p I
<br />
<br />License # I E~I I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIA
<br />SIGNATUREv
<br />
<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 />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />
<br />1111111I1111111111111111111111111I11111111111111I11111I1111111111111111I111111111111111111111111111111111I111111111111111111111111
<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 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 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ii~~~': . , . . , . , , , , . , , . , . . . , , , . , . . , , , . . . , , , , , , , , , , , . , . , , , , , , , , , , , . . , , , , , . , , , , . , , , , , , , , , , , , , '. . . , , . , . , , , , . , , , , . , , , . . , , , , , . . . . , . . , . , , , . , . , , , , , , , , , ,
<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 PE.~~f~J>Plication OnlY)
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