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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
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<br />D{) /71:aavtr
<br />8Lt/D I
<br />I
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address
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<br />Fee Simple Titleholder Namel
<br />
<br />"/
<br />-377-9/0
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />l5"bl? G4iL
<br />I
<br />
<br />L?LVD
<br />
<br />I LOT# I
<br />
<br />PARCEL ID#I // .26..2/ a;(tJ t?9ooo 00 $/0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />I
<br />
<br />D NEW CONSTR D ~ ADD/All D
<br />D INSTALL [a' REPAIR
<br />PROPOSED USE D SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I ~~ ~'Y\ll-'\'S ~~. -r ~_\ qn\""":>
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I
<br />TTIIII"IIII"IIIIIII'IIIII"'IIII"lllll'IIIIIIIIIIIII1111'11111111111111'1111"'1111111111111"'1111"111"111111111111111"1111111111111"11111
<br />
<br />1$ I
<br />I~ ~OO 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111
<br />
<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />0 BUILDING
<br />ULY"' ELECTRICAL
<br />0 PLUMBING
<br />0 MECHANICAL
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<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />AMP SERVICE ~ PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />License #
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<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111
<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 subdivisions/large 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~~~t;~~~': ' , , . , , , , , , , , , , , . , . . , , , , , , , , , , . , . , , , , . , , , , , . , , , , , , , , , , , . . , , , , , , , , , . , , , . , , , , , , , , . , , , , . , , , , , , , , , , . . , , , , , , , , , , , , , . , . . . , , , , , , . , . , , , . , . , , , . . ,
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (PloUSurvey/Footage)
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<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN I ~. - ../// d~ A~ :./- )
<br />SIGNATURE . ~r'~
<br />Address 1.391// hT7?.{l Rc/
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<br />PLUMBER I
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<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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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />License # I
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<br />I ~~f !~e Ii-:,f!r{:
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<br />License # I EC.-OOO/~ (;,~
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />License #
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<br />FEE CURRENT
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<br />License #
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<br />FEE CURRENT
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