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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 />Fax-813-780-0021
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<br />WORK PROPOSED
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<br />I
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<br />E3 NEW CONSTR ~ ADD/ALT D
<br />INSTALL REPAIR
<br />PROPOSED USE D SFR COMM D OTHER I I
<br />TYPE OF CONSTRUCTION ~ BLOCK D FRAME D STEEL D OTHER I I
<br />
<br />DESCRIPTION OF WORK I /p~'114"'^- .:zen- O,J7UZ;'T~ ~ '11.1 (JJo~ tAla'^- ,0'\1 c~"'c.'r.1
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<br />?-JI1I'(
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<br />/3 t-vJ)
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<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Date ~eceived
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<br />Owner's Name
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<br />Owner's Address '7 yO'>
<br />Fee Simple Titleholder Namel '
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<br />SUBDIVISION
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<br />o
<br />lJ5V~/~
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<br />~'-'-
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<br />LOT #
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<br />JOB ADDRESS
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />DEMOLISH
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<br />D
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<br />1$ I
<br />1$ Y;/3-/f: I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ 1
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<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
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<br />ELECTRICAL
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<br />AMP SERVICE ~ ~
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />ta
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />I
<br />I
<br />'- L- 9-
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<br />BUILDER
<br />SIGNATURE
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<br />License #
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />I~~
<br />
<br />~E~;Z- ~~~
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<br />License # I L:"<< ~ i
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />License #
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />License #
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1
<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 on site, 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 on site, 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~~~ii~~~': ' , , . , . , , , , , , , , , . , . , , , , . , . , . . . . . , , , . . . . , . . , . . . . . . . , . . . . . . . . , , . , . . , . . , . . . . , , , . . , , , , . , . . . , . . . , . , , , , , , , , . . . , . , , , , . . . , . . , , , , , , , . , , , , , , , , , . , ,
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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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