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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 />if10tV
<br />
<br />Date Received
<br />
<br />
<br />/ Owner's Name
<br />
<br />/ Owner's Address Is .2..0S-/9 ""'~.57:
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
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<br />Fee Simple Titleholder Address
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<br />,/ JOB ADDRESS
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<br />5' .).()5',-/9 -r~ ST
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<br />LOT #
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<br /> I PARCEL ID#/
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH
<br />INSTALL REPAIR
<br />SFR D COMM D OTHER I '5'#1: V
<br />BLOCK D FRAME D STEEL D OTHER I
<br />
<br />SUBDIVISION
<br />
<br />E3
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK" I
<br />
<br />BUILDING SIZE /' I /,;.'X I c.f. ' I SQ FOOTAGE I HEIGHT I
<br />11111111111111'111111111111.111111111111"'1111111111111111"1111111111111'111111111111111111111"1'1111111'""11111111111111111111111111"'11111
<br />
<br />/ 1$ 3..1 ~S- I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111111111111: I '.' ~I~:~~~II ~';;'.:..!~ IIIII~~~ ';111 ~ I ~5'" 0<1"""" '1'''''''''' *I~~~ 11111:;;;;'::111111111111111111111111111
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<br />BUILDER' Dr\ . COMPANY ~ -e
<br />SIGNATURE ' REGISTERED Y / N FEE CURRENT Y / N
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<br />WORK PROPOSED
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<br />0 BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />3 /)0.3 - {52$V
<br />~(~
<br />/J~~
<br />
<br />Address
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<br />
<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 />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
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />II11111I111II1111I111111111111I111I1111I1I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 wI 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 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.
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
<br />
<br />i
<br />Driveways-Not over Counter if on public roadways..needs ROW
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