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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 />11 g'?
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<br />Date Received
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fax-813-780-0021
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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 />Fee Simple Titleholder Address
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<br />LOT #
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<br />I 3d ')03 /:~{I..ut
<br />I JUp~ U, U~e PARCELlD#13S"~S-- ~\- 0<9s14- ~.- /)pJo
<br />~. (OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR ADD/AL T D SIGN D MOVE D DEMOLISH
<br />gr INSTALL REPAIR
<br />PROPOSED USE b!:1 SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D
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<br />DESCRIPTION "'WORK I e...... ~ -:sIo~
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<br />BUILDING SIZE I SQ FOOTAGE : c:JC? HEIGHT I
<br />1111111111111111111111111111111111111111"11'11111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />D MECHANICAL r
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<br />D GAS ~ ROOFING
<br />FINISHED FLOOR ELEVATIONS
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<br />BUILDING
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<br />1$ (,500. 00
<br />1$
<br />1$
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<br />AMP SERVICE
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />W.R.E.C,
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<br />ELECTRICAL
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<br />PLUMBING
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<br />OTHER I
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<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />11I111I111I1I11111111111111111111I1111111111I111111111I111I1111I1111I1111I1111111111111111111111111111I11111111I1111111111111111111111111111111111
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<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 onsile, Construction Plans, Stormwater Plans wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 />i:ii~~~ij~~~': . . , , , . . . . . . . , , . . , , , . . , , . . . , , . . . , , , . . . , , . . , , , . . , , , . . , . , . . . , . . . , , , . . . , , , . . . , , . . . , , . . . . , . . . . , , , , , , . , . . . , , , , , , . . . , . , , , , , . . . , . , . . . . . . , , . . . . .
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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
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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 />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />OTHER
<br />SIGNATURE
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<br />Address
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<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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<br />OTHER
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<br />DYES
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<br />DNO
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<br />YI N
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<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />Y/N
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<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />License #
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<br />YI N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />License # I
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<br />I 1'1r."I ~G
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<br />License # I c?oc. I.:) Q S- r o..r-
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