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<br />812:-780-0020
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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 />Date Receivled
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<br />J-e..
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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 />...11..111.1
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<br />Owner's Name
<br />
<br />Owner's Address
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<br />Fee Simple Titleholder Namel >~
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<br />Fee Simple Titleholder Address I .s~
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<br />,.---- .
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<br />I Z> f Cc '?-:J.. ~ e vno-nL
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<br />I~~~
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<br />D NEW CONSTR D ADD/ALT D
<br />~ INSTALL D REPAIR
<br />PROPOSED USE rn SFR D COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I Mb h.l~
<br />
<br />DESCRIPTION OF WORK ~~ 1'-) l/iV\~ ~~ Wth~S
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<br />BUILDING SIZE I/JXitli':f73 X ~ It sa FOOTA:E I ~~:;.. I HEIGHT I I (J' i
<br />
<br />111111111111111111'1'11111111'111111111111111111111111111'11111111'111111111111'1111111111111111'11111111'111"111111'1111111'1111111'111111111111
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<br />ClJ BUILDING 1$ I, "lev 6 c~ I
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<br />.
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<br />1$ I
<br />1$ I r.\ I rrJJn"-/~
<br />1$ I VALUATION OF MECHANICAL INSTALLATION 0 ~t ;--;v
<br />
<br />D r-l <;;~<tJ I
<br />ROOFING L-J SPECIALTY D OTHER
<br />I FLOOD ZONE AREA DYES
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<br />~, I LOT# I 93
<br />PARCELlD#1 {}J."" ~ -8-I-(!)~o ~() tJDcJO - OQ3(J
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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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 />DEMOLISH
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />ELECTRICAL
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<br />AMP SERVICE
<br />
<br />D
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<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
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<br />D
<br />D
<br />D
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<br />PLUMBING
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<br />MECHANICAL
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<br />D GAS
<br />FINISHED FLOOR ELEVATIONS I
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<br />DNO
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<br />
<br />
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<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 /> License #
<br />Y/ N FEE CURRENT
<br />
<br />Y/N
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<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />License #
<br />11111111111111111111111111111111111111111I1I111111111I111111111111111111111111111111I1111111111III1111111I111111111111111111111111
<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 onsile, 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.
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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 AlC Fences (Plot/Survey/Footage)
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<br />Address
<br />111111111111111
<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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