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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 />Date Received
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name L- --r-D
<br />Owner'sAddress 1109 \:L 5lc~ St-. !'1 T~fJ~ I ~.r""-,,-,-,
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />15'b6) ~d ~QO~
<br />IIr~kn~ MObLL~rco<Ll
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />LOT #
<br />
<br />PARCELlD#1 \0- J....~. ;;)....\. 00;)0. COlD::). aaa0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION DF WORK tk?o.p\CCCL. iAu <r P:>\<:." r~\"r ~., i:\:i"":!
<br />
<br />BUILDING SIZE I SQ FOOTAGE I . HEIGHT
<br />1111111111'1""'1111111111111111'1111111111111111111111111111111'11"""1111111111111'111111111111111'1"-1"111111'1"1111111111111111111111111
<br />
<br />@
<br />D
<br />D
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />e..q \..I:j'f)+-
<br />V
<br />
<br />1$ I
<br />cstJ ELECTRICAL 1$ ~ ~ I
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 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 />11111111111111111111111111111111111111111111'1111111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />rn
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />too
<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 />ELECTRICIA-L-. " - k r I
<br />SIGNATURE.n ~~
<br />Address lP'D bD'1- 't:,lp:L ~Y\'f hlG
<br />
<br />License #
<br />
<br />I COMPANY 1=R~:<-N
<br />. REGISTERED ~
<br />\-1- ?n$'~"l . ~l.-
<br />
<br />I COMPANY I
<br />REGISTERED
<br />
<br />8 e: '- '"t'n 'C.!:J I/1L- .
<br />I FEE CURRENT IG/ N I
<br />
<br />License # 18-- 1:)001 ~S-~
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/ N
<br />
<br />FEE CURRENT Y / N
<br />
<br />Address
<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 />License #
<br />111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 w/ 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~~~ii~~~': ' , , , , , , . , , . , , . , , , . , , , , . , , , , , , , , , , , . , . , . , , . , , , . , . , . . , , , , . . . , . , , , , , , , , . , , , , . , , . , , . , , , , , , , , , . . . . , . , , , . , , , . , , , , . . , , . , , . . , , , , , . . . , , . , , , , , . , ,
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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. (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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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