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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received '7- OG '7 - tt-
<br />
<br />/Owner'sName /?;cH'/1R.h f? /- /~'"N
<br />/" Owner'sAddress I$Z zif ML/Se C'-/'
<br />
<br />
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<br />Owner Phone Number I [II j
<br />Owner Phone Number I ~ /5
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<br />g/3. CjL? ~ 22.-/ ~
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<br />1~ ~ '6'7()'/
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<br />Fee Simple Titleholder Address
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<br />.2b 2 if
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<br />Fee Simple Titleholder Name
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<br />/' JOB ADDRESS
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<br />LOT #
<br />
<br />B
<br />
<br />PROPOSED USE D
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<br />TYPE OF CONSTRUCTION D
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<br />./ DESCRIPTION OF WORK I V//{/,Vc- Pr2IY4CY H,(A::::.e..-
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<br />BUILDING SIZE SQ FOO~GE I / ~S- ~,.(,le4- HEIGHT I 6g' J i
<br />IIIIIIIIIITTTTTTTII . 11111 . I ' 1111 , I1111I111 1111111111111111111111111111111 , . II11111 . 1111 . 11II . , 111I1 , I ' 111111 r . 11111 , , III , 1111I1 P , I1III , 11111 , 1II1I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />B
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<br />PARCELlD#1 \2 - 2~. 2...\ . u~, b. 00000 .UfS70
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />SUBDIVISION
<br />
<br />WORK PROPOSED
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
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<br />D BUILDING ./ 1$
<br />D ELECTRICAL 1$
<br />D PLUMBING 1$
<br />D MECHANICAL 1$
<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />ROOFING
<br />
<br />I
<br />I
<br />I
<br />I
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<br />I
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<br />AMP SERVICE
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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 />.t .fo tJ ry
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<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />BUILDER
<br />SIGNATURE
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<br />./
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<br />
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address License #
<br />111111I11111111111I11111I11111111111111111111111111I11111111II111II11111111111II1111111111111111II11111111111111111111I1111111111II1II11I11I111111
<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 subdivisions/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 w/ 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.
<br />
<br />Di~~~ti~~~':' , , . , . , , , . . , . . , , . . , , , . . , , , . . , , , . . . . . , , . . . , , . . . . . . . . . . . . . , , , . . . , , . . . . . , , , . . , , , . . , , , . . . . , , , , . . . . . , . , , , , . . . . . , . , , , . . . . . . . I I , I I . I I . I . , I . I 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. (A/C 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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