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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 />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />
<br />'Pi-
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
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<br />L~ 7(Pt!J.-
<br />I
<br />
<br />P!2A-tf)O
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<br />PL
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<br />LOT #
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<br />JOB ADDRESS
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<br />PARCEL 10#1
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH
<br />
<br />I
<br />
<br />E3 NEW CONSTR r=J ADD/ALT 0
<br />INSTALL D REPAIR
<br />PROPOSED USE 0 SFR D COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK P FRAME 0
<br />
<br />DESCRIPTION OF WORK LR e !2 oo{.- / 5 JA (fl.J 6 U s
<br />
<br />I SQ FOOTAGE I
<br />
<br />1$ ~69c~ I
<br />D ELECTRICAL 1$ I
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111
<br />t 0V\.J 12... G:,v So 'v Se JL &~ '"R
<br />COMPANY v'"
<br />REGISTERED Y I N
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<br />SUBDIVISION
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<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
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<br />I
<br />D
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<br />OTHER I
<br />
<br />HEIGHT I
<br />
<br />BUILDING SI~E
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
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<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />License # I t!..C 0 -S 7 ~ % 7
<br />
<br />
<br />Address
<br />ELECTRICIAN /0/ t4
<br />SIGNATURE
<br /> ,
<br />Address
<br />PLUMBER A/ //1-
<br />SIGNATURE
<br />Address
<br />MECHANICAL 1&/t4
<br />SIGNATURE
<br />Address
<br />OTHER
<br />SIGNATURE
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Y / N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br />
<br />Address License #
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111
<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 w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivlsiDns/large projects
<br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />Di~~~ii~~~': ' , , , , , , , , , , , , , , , , . , . , . , I I , . , , I , . . , , , , , . , , , , , , , , . , , , , , . , , , , , , , I , , , . . , . , , , , , , . . , , , , , , , , , , . . . , , , I , , , , . , , , , , , , , , , . . , I I , , , , , , , , , , , , , , , , , , . , ,
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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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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