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<br />813-780-0020
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<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />AI A-/J~A-r /td
<br />
<br />I PARCELlD#1
<br />
<br />D NEW CONSTR c=J ADD/AL T D
<br />D INSTALL CJ REPAIR
<br />
<br />PROPOSED USE D SFR D COMM D
<br />
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I A ~ 4P\. 5Y 5k /Yl .4d~ h j, <l/
<br />I
<br />
<br />BUILDING SIZE I sa FOOTAGE I I HEIGHT I
<br />II 1111111 II 11111111 11111 1 ' I 1111 11111 III I 111111 11111 11111 1111 III I I I 1 , ' 1 , 1 1 1 . I ' 1 1 ' 111111 III II I 1 II 1111 II II ' , 1111 II I 11111 III 11111 ' II 11111111111111111 I
<br />
<br />50 l/ f3
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111I11111111111111I1111111111111111111111111111I1111I1111111111111111111111111I11111111I1111111I1I1111111111I1111111111111111111111111111111111111
<br />
<br />0 BUILDING
<br />0 ELECTRICAL
<br />0 PLUMBING
<br />0 MECHANICAL
<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 />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />
<br />COMPANY I 5/l-c/c..If.~ Ek.c~l4-/C 5Y5~sl
<br />REGISTERED ~ 1 N r FEE CURRENT _ Y / N I I
<br />
<br />371/1' iI~~J.~'t.- ,i//4L+ .DAd....J/~y License # Icrc::Joo/CJr?
<br />
<br />111111111111111111111111111111111111111I11111111I1111111111111111111111111111111111111111111111111111111I1111111111111111111111111
<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 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 />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 />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y 1 N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<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 />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 />;t{ ~~~J
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~tj~~~':' , , , , , , , , , , , . . . , . , . , , , , , , . , , , , , , , . , , , , . , , , , , , , , , . , , , . . , . , . . , , , , , . , , , , , , , , , , , , , , , , , , , , . , , , , , , , . , , , , , , . . , , . , , , . , , . , . . , , , , , , , , , , , , , , , , , , , ,
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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 NC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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