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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
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<br />Owner's Name
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<br />Owner's Address I ~8 ~-Cl C'"'\
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<br />Fee Simple Titleholder Namel
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<br />k e yY\.~,\(...
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<br />Owner Phone Number 8 i 3 ~ ? 8<3 - e -3 ~B
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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 />JOB ADDRESS I '3 S'::;O c,
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<br />R-e Vy\.~'-('"
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<br />LOT #
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<br />PARCELlD#1 o~- J.-<C .~ \ ~ (J';).. <.. Cl - QOQOO -- G 806
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />SUBDIVISION
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<br />H- ~ \I ~w
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<br />BUILDING SIZE I ~ I sa FOOTAGE I I \ g.. ~ I HEIGHT I L f.s Fee:+ I
<br />111'111'11111"11'1"11'11'11"11'11'111'1"11'1111111'11'1'1'1'11'11"11'111'11111111;11111'11'11'111'11'11111'11'11'1"11'1"11'11111'11'1111111
<br />
<br />
<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />e- YV\. b ro-.. ~
<br />
<br />DESCRIPTION OF WORK
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<br />R e HH! .\-
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<br />s;
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<br />D BUILDING 1$ ~ qcr{j, 0 \J
<br />D ELECTRICAL 1$
<br />D PLUMBING 1$
<br />D MECHANICAL 1$
<br />D GAS r:6I ROOFING
<br />FINISHED FLOOR ELEVATIONS
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER
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<br />G1dk
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<br />r L f B 75'. I
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<br />C-3
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />PROGRESS ENERGY
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<br />AMP SERVICE
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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 />SPECIALTY 0 OTHER
<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE
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<br />Address I
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<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111I111111111111111111111111111
<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 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
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<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
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<br />l~fu~
<br />I YI N I FEE CURRENT I Y/N I
<br />License # I CC c <is 7 0 elf \
<br />
<br />Y/N
<br />
<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 I N
<br />
<br />FEE CURRENT
<br />
<br />. I Y IN
<br />
<br />License #
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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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)
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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)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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