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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 />10 ~ 5 rr
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<br />Owner's Name
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<br />Owner's Address I ~ I -z..
<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 />10/4.
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<br />JOB ADDRESS
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<br />PARCEL 10#1
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<br />SQ FOOTAGE I 3 0 ~
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />DESCRIPTION OF WORK
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<br />BUILDING SIZE
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<br />I LOT# I
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<br />\ \-Zw '-2.-1 _ 00\0, ,\ %00 ~ 0 \701
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />OTHER I
<br />STEEL D
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<br />OTHER I
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<br />HEIGHT I
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<br />D BUILDING 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 0 SPECIALTY D OTHER
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<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />BUILDER H ~ ~~",,,. I;t'e ,,,, J.il """c. . I
<br />SIGNATURE Y / N FEE CURRENT Y / N
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<br />VALUATION OF TOTAL CONSTRUCTION
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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 />Address
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<br />A-.",'" .
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />OTHER
<br />SIGNA lURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
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<br />Address License #
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<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 />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 onsile, 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~~~ti~~~': I . . . I I I . . I , . . I I , I I I . . I I I I , . . I I , I , , I I I , , I I I , . I , I , , I I . , , I I I , , . . . . , . . , I I I . , I . I , , . I I , , " . . I I I , , , , , I . I I I I . , I , , . . I I I I . , . . , I . , . , , . , . 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 llver $2500, a Notice of Commencement is required. (AlC upgrades over $5000)
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<br />Aglent (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 COUNTE~ PERMITTING (Front of Application Only)
<br />Relroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage) ,
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<br />Dr'lveways-Not over Counter if on public roadways..needs ROW
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