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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />FaX-813-7;t~ ltJ,
<br />
<br />Date Received
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I SOL{ S'" 3/LYY1mCA tht1
<br />13fuTlt'Vter th'~1
<br />
<br />SUBDIVISION
<br />
<br />tv.
<br />PARCEL ID#I
<br />
<br />LOT #
<br />
<br />D NEW CONSTR
<br />D INSTALL
<br />
<br />PROPOSED USE [J;2l"" SFR
<br />
<br />TYPE OF CONSTRUCTION ~ BLOCK
<br />
<br />
<br />DESCRIPTION OF WORK I L. ~
<br />
<br />
<br />BUILDING"" '~FOOTAGEI HEIGHT I
<br />111111111111111111111111111"""'1111111111111111111111111'111-"11111111111111111"11111111111111'11111'"P'IIIIIIIIIIIIIIIIIIIIIIIIII""IIIITT
<br />
<br />10/ ADD/ALT
<br />tJ2I' REPAIR
<br />D COMM
<br />D FRAME
<br />
<br />1;).- aGo 11- CIDO _.~ --0/<10
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />o
<br />o
<br />o
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />~
<br />
<br />1$ 7S00,OC I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS ~ ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11I1111111111111111111I111111I111111111I1111111111111111111I11111111111111I1111111111111111111111111111111111111111111111111I111111111111111111111
<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 />D
<br />D
<br />D
<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 / N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y / 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 ' License # I
<br />
<br />OTHER 4j,W1J:h1 1l_~.A;~ T~
<br />SIGNATURE I / N I ~NU lY/ N I
<br />
<br />Address '2 I..).,U ~ 5.Jl1 License # I c.ec.... I :s .:.{ ..[~-CJ
<br />
<br />11111111I111111111111111111111I111111111111111111111111111111111111111111111I11111I111111111111111111I11111I1111111111I11I1111111111I11111I1111111
<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 w/ 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~~~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. (A1C 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 />
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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