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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />rnfl~dDWbaJ cf
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Owner's Name
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<br />Owner's Address 13 ~ 5 28
<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />13q5~~ fYW.a..c\~~& LV')
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<br />LOT #
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<br />SUBDIVISION
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<br />PARCELlD#ll~ --2(0-2-1 - 01 ~D -o()Ooo. j230
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />BUILDING SIZE SQ FOOTAGE 1.)(40 HEIGHT I
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<br />
<br />WORK PROPOSED
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<br />SIGN
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<br />MOVE
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<br />DEMOLISH
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />OTHER I Kli"-;U"! sh, ",Ie:-s.
<br />STEEL D OTHER I
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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<br />1$ 3 l..f ~I: eO I
<br />1$ I
<br />1$ I
<br />1$ I
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<br />D GAS ~ ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />I11111111111111111111111111111111111I11111111111111111I11111111111111I11111111111111111I11111111111111111111111I111111111111111111111111111111I111
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<br />D
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />ELECTRICAL
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E,C,
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<br />D
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<br />PLUMBING
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<br />MECHANICAL
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<br />VALUATION OF MECHANICAL INSTALLATION
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<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 />
<br />Y/N
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<br />I
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<br />I
<br />I
<br />I
<br />I
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<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />I
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />OTHER I tJi-lIJ-L() f.4~~):7/l~
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<br />SIGNATURE ~ N I FEE CURRENT r'Y)N I
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<br />Address nil- '/RA;{ ~~J~ V'C,IIlj.,:'/. 1 License # I CCCf32- C, r<1r
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<br />1II1111111I1111111111111111111111111111111111111I111111111I111111111111111111111111111111111111111111111111111111I1II11111I1111111111111111111I111
<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 />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 wI 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,
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<br />Di~~~~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)
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<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 AlC Fences (PloUSurvey/Footage)
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<br />Y/N
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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