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<br />Fee Simple Titleholder Name n'fYJ vel I J .J.
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<br />81.> 780-0020
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<br />Date Receivled
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS
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<br />SUBDIVISION
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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 />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 />PARCEL ID#I
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<br />LOT #
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />DEMOLISH
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<br />BUILDING SIZE sa FOOTAGE I I HEIGHT
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<br />D GAS D ROOFING CJ SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
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<br />D BUILDING
<br />IEJ ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />BUILDER
<br />SIGNATURE
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />OTHER
<br />STEEL
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.R.E.C,
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
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<br />License #
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<br />COMPANY
<br />REGISTERED
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<br />License # I ee./ '3 C: t) I :J.6 7
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
<br />1IIIIIIIIIIillllllllllllllllllllllllllllllllllllllllll1111I1111111111111111I1111111111111111I111111111111111111I11I1I1111111111111II11111111111111
<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 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 wI 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 />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />DI~~~ti~~~':' . , . , , , , , , , , . , , , . , , , , . , , , , , , , , , , , , . , . . . . , , , , , , , , , . , . , . , , , , , . . . , , , , , . , , , , , , , , , , . . , , , , . . , , , , , , . , . , , , , , , , , , , . , , . , , , , , , , , , , , , , , , , , , , , , , , , , ,
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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