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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 />
<br />
<br />"?;- y ;- )P" /C
<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 />7.Bt77~
<br />
<br />Lllw;9NP.4 ~ pp/,
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />~$pJo
<br />
<br />LA"" /I j4-' , IJ '- pC? I'
<br /> I PARCELlD#1
<br />NEW CONSTR El ADD/All D
<br />INSTALL REPAIR
<br />SFR D COMM D
<br />BLOCK D FRAME D
<br />
<br />LOT #
<br />
<br />/ JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />DEMOLISH
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />"DESCRIPTION OF WORK I III" -,;, fx;J7. .", r-f'lV(p ~f'JI1"i/r' ""~ ~""V
<br />
<br />BUILDING SIZE SQ FOOTA~E I t,6/ HEIGHT
<br />111111111111 I , 111II1111 1111 ' I ' 111111111 1 " , , , , , 11111111 " , II " III . , III " 1111 " I ' , . 1 1111 . III " 1111111111111 " I " 1111 " " 111111 " 1111 , I , 111111 . 11111
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />~ BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />/1$ ,;; '? I
<br />~J/~
<br />1$ I
<br />1$ 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 />1111111111111111111111111111111111111111'111"1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />/~
<br />BUILDER .
<br />SIGNATURE CZ--,
<br />,
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br /> FEE CURRENT
<br /> License #
<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 />Address
<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
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />License #
<br />111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111
<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 onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 />Di~~~ti~~~': . . . , , , . . . , . . . . , . , . , . . , , , . . , , , , . , . . , , , . . , . , . . , . , . . , . . . . , , , . . , , , . . , . . , , . . , , . . . . , . , . . , , , . . . , , . , , . , , . , , . . . , . , , , . . . . . , , , , , , . . , , , , . . , , , , . , . . .
<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 AlC Fences (Plot/Survey/Footage)
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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