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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 />~q18
<br />
<br />
<br />Date Received
<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 />Fee Simple Titleholder Address
<br />
<br />LOT #
<br />
<br />PARCELlD#1
<br />
<br />I
<br />
<br />r-=l NEWCONSTR r=J ADD/ALT D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I~, /:t 6C, U<<:'.,. -b:, r(')r'> F'lv(J)
<br />
<br />BUILDING SIZE I ' -----' sa FOOTAGE I I HEIGHT I
<br />1IIII,I'Illlt'IIIIIII"III'IIIIII'I'IIII,1111,11111,1111'11'11111111'111'11111"11'111'"11'1111111'11111111'111'lt'IIIIIIIIII'III'11111",III'IIII.
<br />
<br />1$ I
<br />1$ (A;)c) ~ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />D GAS 0 ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'111111111I1I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />D
<br />~/ ELECTRICAL
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />AMP SERVICE ~ROGRESS ENERGY
<br />
<br />W.R.E.C.
<br />
<br />BUILDING
<br />
<br />D
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />License #
<br />11I11111111111111111111111111111111111111I111111111I11111I11111I1111I1111I11111I111111II111111111II111111111III1111111111111111111
<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 w/ 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 />Di~~~ti~~~':' , , , . . . , , . . , , . . , , , . . , . . . . , , , . . , , , . . , , . . . , . , , . , , , . . , . , . . , , , . . . . . . . , . . , . . . . . . . . . , , , . . . , , , . . . . , , , , . , . . , , . , , , , , , . . . . . , , , , , , , , , . , , , . , . , , . , , ,
<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 />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />1\1\11111111\11
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License # I
<br />
<br />IRv'1T ~~~? E7~cfr~
<br />I Y I N FEE CURRENT Y / N I
<br />License # I
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
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