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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Applicatll.ln
<br />Building Department
<br />
<br />
<br />Date Received
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address I +G '-I ~ &41-- L- 'J5.>L- \J b,
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />17&L/3>
<br />I
<br />
<br />JOB ADDRESS
<br />
<br />LOT #
<br />
<br />64LL ~\JD,
<br />I
<br />
<br />~
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<br />o
<br />DESCRIPTION OF WORK I~ t< f~l< (c,R PA 110 /05 'SF
<br />BUILDING SIZE I J ~ 5 SF I SQ FOOTAGE 1/ (oS SF HEIGHT
<br />
<br />1" 11111111111' r ' , , , I , 1111111111111111 r . , I , , , 111111 ' . I , 111111111111111111 ' , , . 1111111 , 11111111111111111111 ' , , , I ' I , , II , II , , ' III , ' , I , III , 11111111111111
<br />
<br />PARCELlD#1
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />D BUILDING 1$ 1 ~ I DO 0
<br />
<br />D ELECTRICAL 1$
<br />
<br />D PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />D GAS D ROOFING
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />'54 -;?) <;.~d./- CbJO-6SfX:J-CX;oo
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />I
<br />o
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />W.R.E.C,
<br />
<br />o
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />o
<br />I
<br />
<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />License #
<br />111111111111111111111111111111111111111111111111111111111I11111I1111111111111111111111111111111111111111111111111I1111111111111111
<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 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 />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />It{~~~ ~~~c/f;:/N P
<br />License # I (,..c.G-OD 92~ I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />DI~~~ti~~~': ' , . . , , , , . . , , , . . , , , . . , , , . . , . , , . . . . , , , . . , . , , . . . . . . . , , . . , . , . . . . , , . , . . , . , , , , . . , . . . . , , , , . . , , , , , . . , . . , , , , , , . . , . . , . , , , , . . . . . . . . . . . . . . . , . , . , , . ,
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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 (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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