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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
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<br />Fo X MOOV' D V-
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<br />OWner's Name
<br />
<br />DESCRIPTION OF WORK
<br />
<br />B
<br />o
<br />o
<br />I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />o A k.. .5 I PARCELlD#1
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />I
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<br />I LOT # I I
<br />() ? - 2ft:, - 2 (-0 I LCJ -OoU<J Cl -0 79'gl
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE 0
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Address I (IJ ) tj 3
<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />SUBDIVISION
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<br />BUILDING SIZE I SQ FOOTAGE I Z. 70U I HEIGHT I
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<br />
<br />1$ c; g-(POr d)
<br />1$
<br />1$
<br />1$
<br />
<br />D GAS ~OFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111111111111111111111111111111111111I111111111I111111111I11111111111111111111111111111111111
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER I
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<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 />WR.E.C.
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address I License # I
<br />
<br />OTHER ~ COMPANY IJu. I{l?)ht-AJNr4Y ~Cli:/~
<br />SIGNATURE ,~~ --------+---"EGISTERED I Y I N FEE CURRENT I Y I N I
<br />
<br />Address I V 6 6 0 X (l S<r I License # I C(! c O.C;;- 7 dt ~
<br />
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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 subdivlsions/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 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.
<br />
<br />DI~~~ii~~~': ' . . , , , . . . , , , , , , , . , , , , , , , . , , . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . , , , , , , , , . , , , , , , , , , , , , , , , . , , , , , , , . , , , , , . . , , , , , , , , , . . , , , , , , , , , , , , , , , , , , , ,
<br />
<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
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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