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<br />813-780-0020
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<br />Date Received
<br />
<br />
<br />.- I 0- () 7
<br />~?1c YI
<br />I 6S-c:-t? /b~. sA
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />IV0e:<?
<br />I
<br />
<br />/6--<< ~ I LOT # I
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<br />I PARCELlD#1 11- 2ft; ~ ~/- DO (0 - {'/Ooo ' D /9tJ
<br />
<br />NEW CONSTR GZJ ADD/ALT D
<br />INSTALL D REPAIR
<br />PROPOSED USE : ~( SFR D COMM D
<br />TYPE OF CONSTRUCTION BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I.~~ ~ ~~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT
<br />1111'1111"1'1'11111111111111'1""111'11'111111111111111111111111111111111111111111111111111111111'11'111111I1111I1I11111111111111111I11111111111
<br />
<br />1$ I
<br />1$ I
<br />1$ ~t6. C7/ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1I1111111111111111111111111111111111I1111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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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
<br />
<br />~
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Y/ N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />! 9a,nteY{ ~
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~/]?~ O'rc/J.~
<br />Y / N I FEE CURRENT
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />11111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I
<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 onsile, 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.
<br />
<br />jji~~~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)
<br />
<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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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