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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 />Owner's Name
<br />
<br />AlA) fr-
<br />
<br />Owner's Address I S 1/9
<br />Fee Simple Titleholder Namel
<br />
<br />It-3o-6
<br />pfJ6
<br />M!2
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<br />
<br />
<br />
<br />Date Received
<br />
<br />DESCRIPTION OF WORK
<br />
<br />Ed-
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<br />lu
<br />
<br />ADD/All
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />I
<br />I
<br />I LOU I I
<br />
<br />
<br />PARCELlD#\ ll-~ 6 -2/- IJ 0/0 - IS ;/t90 - {)030 I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />o SIGN D MOVE 0
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<br />Owner Phone Number
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<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />ST
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<br />'2 f/-/LL-'s
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />~I/ I
<br />
<br />:z.~ 57
<br />
<br />JOB ADDRESS
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />DEMOLISH
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE I I SQ FOOTAGE I I HEIGHT I I
<br />111"11'11'111111'11'11'11'11'1111"111111111'111'11111111'11'11'1111'111111111111'111;'1111111'11'11'11'11'11'11'1'1111111'11'11'1111'11111'1"11
<br />O BUILDING :$ ~rJ:
<br />O $ j/'i 80, . VALUATIONOFTOTALCO~UCTION D
<br />
<br />ELECTRICAL , _ AMP SERVICE L--J PROGRESS ENERGY W.R.E,C.
<br />
<br />o PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111
<br />
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE ,
<br />
<br />Address I
<br />
<br />OTHER I'~ ~ COMPANY /200/'/#0
<br />SIGNATURE '--Iv, REGISTERED FEE CURRENT Y / N
<br />
<br />Add.... I r 0 IS 0 'i- I 3 "s 0 c. ;: (... > J s261 Uoen..' 1 Jlc- 0& </.2.0/ I
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<br />11111111111'111'111 IIIIIII'IIIIIIIIIIIII~II~IIIIIIIIIIIIIIIIIIIIIIIIIIIII1111111'111111111111111111111111111111111111111111111111I111111I1111II1
<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 />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 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.
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />DI~~~ti~~~':' , , , . , , , , . , , , . . , , , , , , . , , , , . , , . , . , , , . , , , , , , , , , , . . . . , , . , , , , , , , , . , . , . , , , , , , , . . . , , , . . , , . , . . . , , , , , , , , . , , , . . , , , , , . , , , , , . , , , , , , . , . , , , , . , , , , , . ,
<br />
<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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