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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />l~qCf55
<br />1-
<br />
<br />W1rL Or, 2eptyLb.U1S Fl. ~~42 I LOT# I
<br />PARCEL ID#1 \2- 2Lo. - 2' - CD3D -ffi\C0 - enl D
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />JOB ADDRESS
<br />
<br />I
<br />
<br />~ ADD/ALT
<br />~ REPAIR
<br />o COMM
<br />o FRAME
<br />
<br />S'n
<br />
<br />D
<br />D
<br />D
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />D NEW CONSTR
<br />~INSTALL
<br />OZJ SFR
<br />D BLOCK
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />SQ FOOTAGE
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<br />
<br />00
<br />
<br />I
<br />I
<br />I
<br />I
<br />o
<br />I
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />~8l{~),
<br />1$
<br />1$
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
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<br />D
<br />
<br />D
<br />
<br />D MECHANICAL r
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<br />o GAS ~ ROOFING
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
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<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />HEIGHT I
<br />
<br />o
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />111111111111111II11111111111111I111I11111I11111111111I1111I11111I111II11111111111II1111111111111111I1I1I111111I1II111111111II1111111I1111111111111
<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 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 />
<br />~
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />ELECTRICIAN COMPANY
<br />SIGNATURE REGISTERED
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
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<br />
<br />It2lJrYYln Rmnro
<br />~ y I~' t. FEE CURRENT . :Jl Y / N I
<br />License # IrC' c l~ sSDS
<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 />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
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<br />Di~~~ii~~~':' , , . . , , , , . , . , , , . , , , , . . . , , , . . , , , . . , . . , , I . . , . , . . , . , . , , , , . . , , . . . , , , . . . . , , , , . . , , , . . , , , , . , . , , , , . , . . . . , . , . . , , , , , , , . . . , , , . , , , , , , , , . , . , , , , , , , . .
<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
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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