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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />Owner's Name :r:.......c.
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<br />Owner's Address ~k [)r. k/55/~m'et: FI.3'-17y
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<br />Fee Simple Titleholder Name
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS 1,003 I.:L rA sI- Zer pL,r A,I/; ,c/.. 33S-'I1 LOT #
<br />SUBDIVISION I PARCEL ID#I t1;l. ;2&, :2.1 ~CJ () tJ (!JOltJO 0011
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED B NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM I?'I OTHER I /15 "~,,. f'i;ee 1'1,.,'5.1-41
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<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I XC 4-!f14t:). ('d
<br />DESCRIPTION OF WORK I
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<br />BUILDING SIZE sa FOOTAGE I HEIGHT I
<br />"1'111111111111111111111'111'111"11111111"'11111111111111""1111"111111111111111111111""'1"'1111111'""11""111111"11111111111111111111
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<br />1$
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<br />1$
<br />. ?~2... ,;-V
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<br />1$
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<br />1$
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />1111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111I111111111111111111111111111I11I11111I11I11
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<br />D BUILDING
<br />~ ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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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
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<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 />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />I
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<br />I
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />License #
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<br />~t.:'.;z~~N I:::%;h - uJ~
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<br />Address J?//I hM~~d 2-r~I'.4r/k Fr.. .33~~
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<br />COMPANY
<br />REGISTERED
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<br />A-I-If~ Declrlc
<br />I & / N I FEE CURRENT
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<br />it.;ZJ 7
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<br />License #
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<br />I(Y/ N I
<br />I EC-CJt?o/?(,fj
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y / N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />YfN
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<br />License #
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111I11111111111111
<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.
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<br />DI~~~t;~~~': ' , , , , , . , , , , . . , , . . , , , . , . , , , , , , , , , , , , . , . . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . . . , , , , , , , , , , , . . , , , , , , , , , , , , , , . . , , , , , , , , , , ,
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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)
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<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 (Plot/Survey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
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<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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