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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 Phone Number G::; () -~l ,~
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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 ~O -\
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<br />Owner's Address I ~)C:S C'0\\~~'\Yx"'t( 0\~ QcJ I
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<br />Fee Simple Titleholder Namel I
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />h~G26.\\~\~ Le~\~\\\~ \=\.
<br />10\0 ,,",4L~~ I PARC~~ID#I
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<br />E3 NEW CONSTR t=J ADD/AL T D
<br />INSTALL D REPAIR
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<br />PROPOSED USE 0 SFR D COMM 0
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<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
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<br />DESCRIPTION OF WORK 111e~\ ,~""
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<br />BUILDING SIZE ~Q~ SQFOOTAGEI~~ I HEIGHT I I
<br />1II1111 , , . I , I , . III III ; I , 1111 . 1I111 III III III I I II , II ., III ., 11111 . . 1111111111 , 1II111I ' 1111 . 1111111111 .. 11111 . . I III , 1111111 III , II , ., III 111111 III ' III .,
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<br />LOT #
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<br />SUBDIVISION
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0 ~
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<br />OTHER I
<br />STEEL D
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<br />WORK PROPOSED
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<br />OTHER I
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<br />D
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<br />1$ I
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />1II111II1111I1111I111I111111111111I111111111I1II1111I111II111111111I111111111111I1I1I1111111111I1111111I11I1111111111111111'1111111111111111111111
<br />1
<br />I
<br />I
<br />I
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<br />I
<br />I
<br />I
<br />I
<br />I
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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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 />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE
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<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />I
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE
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<br />Address I
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<br />~:;'.i."TURE ~;,~~~~ I
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<br />Address
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />YI N
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<br />FEE CURRENT
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<br />Y/N
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<br />COMMERCIAL
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<br />License # I
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<br />~~:~:R~~ ~\~~'2~~\ I Y/N I
<br />License # ~E0 '<0\6\~~
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<br />1111111111111I1111I111I1111II111111111I111111111111I11I1111I11III11111I111I11I1111I11111111II1111I111111111111II11111I1111I11I11111I11I11I11111111
<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 subdivisionsllarge 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 />SIGN PERMIT
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<br />DI~~~ti~~~': ' , . . . . . . . . . , . . . . . . . , . . . . . . . . . . . . . . . . , . . . . . . . . . , . . . . , . . . . . . . . . . . . . . . . . , . . . . , . . . . , . . . . . . . . . . . . . , . . . . . . . . . . , , . . . . . . , , . . , . . . . . , . . . . . , , . . . . .
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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 A1C Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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