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<br />8121-780-0020
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<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />. .
<br />Date Received
<br />111111111111
<br />
<br />Owner's Name
<br />
<br />s.
<br />
<br />ITI/
<br />
<br />Owner's Address
<br />
<br />z
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address I
<br />5155 I ;::; " ~ s f-
<br />
<br />lV.rcs~ I/; 1/125
<br />
<br />JOB ADDRESS
<br />
<br />;:4 -z r
<br />
<br />
<br />2~
<br />
<br />h "JJS'I2.
<br />
<br />10 "2(' -d/ - t//IO-rfltJOtxJ - 0/.5'0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />LOT #
<br />
<br />I
<br />
<br />D NEW CONSTR D . ADD/AL T D
<br />D INSTALL ~ REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
<br />
<br />DESCRIPTION OF WORK l-rea, 6.H' )t. / e r l)~ r ~S" ( d ~ h C -c.. '3 -f-q b GA- F,)' h "~74J
<br />
<br />BUILDING SIZE I " I SQ FOOTAGE I 2-000 I HEIGHT I . I
<br />
<br />."...111......,........................11.11....111.............:11...11..'..111....111...11.....111............111.11........111.1.1111.1111.....11
<br />
<br />D BUILDING 1$ 31~O I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />D GAS ~ ROOFING 0
<br />
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />SUBDIVISION
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />I I , , . . . , , I I . . I , I I I I , I , I , , I I I , I I , I . , . , , I I . I I , I I I . . . , , , I . , I I I I . . I I , , . I , . I . . I I . . . , , . . , , I I I , I I , , . I , I , I I , . . I I P . I I , r . I I I I II I , 1 . . . , , . I' . I . I , . . . I , . . I . . . . ~
<br />
<br />BUILDER COMPANY
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br />Address License #
<br />ELECTRICIAN COMPANY
<br />SIGNATURE REGISTERED I Y/N FEE CURRENT Y/N
<br />Address License #
<br />PLUMBER COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address License #
<br />MECHANICAL COMPANY
<br />SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br />Address License #
<br />~:":TUR~ ~ ?7-L'/ COMPANY rh ;./~ (lr~<.J." ~cr/":'Z
<br />REGISTERED Y / N FEE CURRENT
<br />Address 37t.2S- 1-( -IT: eoJSl License #
<br />
<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 w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large 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 onsile, 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111
<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. (Ale 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 />
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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