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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-78(}'0021
<br />
<br />Date Received
<br />
<br />
<br />
<br />C.e...{\
<br />
<br />I Owner's Name \J i e.,14 l
<br />/. Owner's Address lLaJ y <l R-( cil1-e.vJ ~ ~
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />/ JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I (jIY~
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<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />Ur~A\,-',')\S ~C 33'>'1? I LOU
<br />
<br />PARCEL ID#I ~'3-2(o -2\ - 0\"30 ' 00000,. 61Lt 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />SUBDIVISION
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<br />B
<br />D
<br />D
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />E3
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
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<br />.,. DESCRIPTION OF WORK W~ ~a:::;J~ - \()\e ~ A- L
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<br />BUILDING SIZE I I sa FOOTAGE I I HEIGHT I I
<br />I II I I I I I I I I I I I I I ~ I , I I I I I I I I ' I I , I I ' I I I ' I I ' I I , I I I I I I ' I I , I I I I I ' I I I I I I I , I I I I I I I I I ' I I , I , I I I ; I I I , ' I I I I . I I ' I I I I I , , I , ' I I ' I ' I I I I , I I ' I I I I I ' I I I I I I I , I I ' I I I I , I
<br />
<br />D BUILDING / 1$ tt.l500 . uD I
<br />
<br />D ELECTRICAL 1$ I
<br />
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<br />D PLUMBING 1$ I
<br />
<br />
<br />D MECHANICAL 1$ I
<br />
<br />
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />OTHER
<br />STEEL
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<br />I
<br />D
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<br />OTHER I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C,
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />jJcD/
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />DYES
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<br />DNO
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<br />BUILDER /
<br />SIGNATURE
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<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
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<br />I
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<br />COMPANY II
<br />REGISTERED
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<br />)fo ~ ('
<br />r Y / N
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<br />Ov-J/7er
<br />FEE CURRENT I Y / N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<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 />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address License #
<br />
<br />1I1111111111I11111I1111111I111111111111I1111111111111111I11I1111111111111111111I1111I1I11111111111I1111111111111111111111111111111111111I1II111111
<br />
<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 onslte, 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~~~tj~~~': ' , , , , , , , , , . , , , , . , , . . , , , . . , , . . . , , , , , . , , , , . . , , , . . , , . , , , , , . . , , , , . , , , , . , , . , , , . . , . , . . , , , . . , , , , , , , . , I , , , , , , , , . , . . , , , , . , , . . , . , , , , , , , , . , , , , , , , ,
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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. (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 A1C Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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