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<br />Owner's Address h' \ \
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<br />Fee Simple Titleholder Namel
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<br />
<br />Fax-813-780-0021
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<br />qi
<br />~'o/
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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Date Received
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<br />Owner's Name
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Fee Simple Titleholder Address
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />I LOT# I
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<br />l \ ' Zt,., ., 2\ - Db \ L"J ~ 2cfZ Cib .- 6\ 4-0 I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
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<br />JOB ADDRESS
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<br />'3" i \ '-.0
<br />
<br />\ -, -H"'. 5 t-
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<br />SUBDIVISION
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<br />PARCEL ID#l
<br />
<br />I
<br />
<br />8 NEW CONSTR D
<br />INSTALL D
<br />PROPOSED USE D SFR 0
<br />TYPE OF CONSTRUCTION 0 BLOCK 0
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<br />DESCRIPTION OF WORK l&.( c- ~"""~ ~
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<br />BUILDING SIZE I I SQ FOOTAGE I! I HEIGHT I I
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<br />II"""""""""""""""""""""""""",.",.", .."".""""",.,."".""...,",..,....,""',.,..",""..1..'.'..,...,."..
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<br />o BUILDING 1$ 1 VALUATION OF TOTAL CONSTRUCTION
<br />o ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
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<br />o PLUMBING 1$ I ~
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<br />5Q MECHANICAL 1$ 3700-. csO I VALUATION OF MECHANICAL INSTALLATION
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<br />o GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />
<br />I I I ' , 1 , ' I ' , , , , , I 1 ' , ' , , , , , , , , , . , , I . I . , . . , , , , , , , I ' , 1 ' I ' , ' , . , , I ' . , ~ I ' , , , , , , . , . , , , , , , ' 1 ' 1 ' 1 ' 1 ' I . I ' , , I ' , , . 1 ' I , , , , 1 ' 1 . . . I ' , , , ' , , I . I . , , , , , , ' . , I ' I ' I ' , . , , II
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<br />
<br />~~~~RE I 1 ;~~::::; I I Y I N FEE CU",,'NT Y I N
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<br />Address I License # I
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<br />ELECTRICIAN i COMPANY I
<br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N
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<br />~~I ~~# I
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<br />PLUMBER I COMPANY I
<br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N
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<br />Address I License # I I
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<br />X MECHANICAL i A1 -- '. J. "- LJ -P'- COMPANY I ~~ t!r,e ~ ~AG I
<br />SIGNATURE :~ ~ REG"TERED ~i-;'L I FEEe"",,'" I y'~'T""-
<br />
<br />Address License # I I
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<br />OTHER I COMPANY I
<br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N
<br />
<br />WORK PROPOSED
<br />
<br />D
<br />D
<br />o
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />
<br />OTHER l
<br />
<br />OTHER
<br />STEEL
<br />
<br />D
<br />
<br />W.R.E.C
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<br />""'~~~~~" 1"""""""""""""""" """,", , '1""""'" " """" ! """"""'" "" ;:::;,~ ""1"",,, """""""""""" !
<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, Storm water Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsflarge projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />"-'PROPERTY SURVEY required for all NEW construction.
<br />11111111111111111111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111
<br />DIrections:
<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 cqntractor) 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 />Driveways-Not over Counter if on public roadways..needs ROW
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