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<br />813-780-0020
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<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 />Owner's Name i=- J r
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<br />Owner's Address I 3 Oft;CJ :l ~~ )oJ L p
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<br />Fee Simple Titleholder Namel
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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 />Fee Simple Titleholder Address I
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<br />I 3i~1';{ ~ocJ {p
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<br />1~~L.-l"J GsM-Cf I PARCELlD#1
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<br />D ~EW CONSTR D
<br />~/ INSTALL D
<br />PROPOSED USE ~ SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
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<br />DESCRIPTION OF WORK I ~ k~ SL';j~
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<br />BUILDING SIZE I I ' SQ FOOTA~E I n 00 HEIGHT I
<br />TTfTTTlnm." 1111"'111111111111 rill' 'IIIII'~ 11111"111111111"111' "11111111111111' 11111111111' 1111'"'111" "111"111"1""'"1'" 11"1111'"111"111"111 ,
<br />Q2( BUILDING 1$ 3S-'O. otJ I VALUATION OF TOTAL CONSTRUCTION
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<br />o ELECTRICAL 1$ I
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<br />o PLUMBING 1$ I
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<br />o MECHANICAL 1$ I
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<br />o GAS Q2(" ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />I1I1I11I1111I1111111I111111111I111I11I1I1111111I111II1III11II11II1111I11111I11111II1111I1111I111I1111111111111111111111111111111111111111111111111
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />LOT #
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<br />I~'I
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<br />13-){,-J.J - 01 <t C)-a1:Ja::;- OJ 40
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />AMP SERVICE
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<br />W.R.E.C.
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<br />PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION
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<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.
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />MECHANICAL
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />OTHER
<br />SIGNATURE
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<br />Address
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<br />RESIDENTIAL
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Y / N
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<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />Y/N
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<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />License #
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<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />License # I
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<br />~.1.1'~
<br />FEE~T ...J I Y/N I
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<br />License # I <:Y'~ /1:J.S )-0 S-
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<br />DI~~~ti~~~': ' . . . , , , , 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)
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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 NC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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