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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 />/ awn.e. Add",.. 139'1:r PIle./4y POA H tl'd
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<br />Fee Simple Titleholder Name
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />
<br />Date Received
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />SUBDIVISION
<br />
<br />Ilf9/7
<br />I
<br />
<br />GftL L
<br />
<br />tS/J()
<br />
<br />LOT #
<br />
<br />/ JOB ADDRESS
<br />
<br />WORK PROPOSED
<br />
<br />PARCEL ID#I
<br />
<br />~
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH
<br />
<br />/0
<br />
<br />E3 NEW CONSTR 0 ADD/AL T
<br />INSTALL D /REPAIR
<br />PROPOSED USE 0 SFR L:1Y COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D
<br />
<br />/OESCRIPTIONOFWORK I ~ ~ ~ ~. fVG -ro 2 '
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />TII.'II""IIII.III.IIII""'IIIIII...III.IIIII.'.II.I1111111111.11.111111111111111111111111111111.111111111IIIIIIIIIIIIIIIIIIIII'IIIIIIIIIIIIIITT
<br />1$ I
<br />1$ I
<br />/1$ gOD. I
<br />1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
<br />
<br />11111I11111111111111111111111111111111111111I1111I11111111I111111111111111111111I1111111111111111111111I111111111I1I111111111111111111111111111111
<br />I
<br />I
<br />I
<br />
<br />OTHER I
<br />
<br />o
<br />o
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R,E,C,
<br />
<br />PLUMBING
<br />
<br />o
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE ,
<br />
<br />Address I
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I 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 License #
<br />11111111111111111111111111111I11111111111111111111111111I111I1111111111111111111111111111111111111111111111111111111I11111111111111111111111111111
<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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans,
<br />....PROPERTY SURVEY required for all NEW construction,
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<br />Dl~~~t;~~~': ' , . . . , , , , . . , . . , , , . . , , , . . , , , . . . , , , . . . , . . , . . . . . . , . . , , , . . . , , . . , , , . . . . , , , , . . , . . . . , , , . . , , , . . . , , , , , . . . . . . , , , , , . . . . , , , , . . , . . . . , , . . , . , , , , , , , , , ,
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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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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