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<br />813-780-0020
<br />
<br />.
<br />Date Received
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />OWner's Name i ~e ~ Pr
<br />Owner's Address Is is "30 o-L.\.-h\ "'S\-
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />15630
<br />I
<br />
<br />E3
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I \2e r 0D(:' - Sa ' ,,~ i " ~ - "3 '-> "f f
<br />
<br />BUILDING SIZE I SQ FOOT AG: _ HEIGHT I
<br />111111111111111111"111111111111111111111111111111111111111111111"1111111111111111111111111'111111111111'""11111111"'111111111'111111111"1111
<br />
<br />1$ dYOD, 0--0 I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'11111111111111111I11111I111111111111111111111111I1111111111111111I1II11111111111111111111111111111111
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />~ '--\:-tn. -S~
<br />
<br />LOT #
<br />
<br />PARCEL ID#II'2 -
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />2lo -2..-l 0070- 00000 - D \ 'SO
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />D
<br />
<br />W,R.E,C,
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />a \ ~e"D (2-~'\
<br />rv C~--\
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />)G~N~TURE I ~4A- ~
<br />
<br />
<br />Address I License #
<br />III1111II11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I11111111111111I1I
<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 on site, Construction Plans, Stormwater Plans wI Silt Fence installed.
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvisionsllarge 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />COMPANY
<br />REGISTERED
<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 />Driveways-Not over Counter if on publicroadways..needs ROW
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