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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />- Owner's Name
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<br />- Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />_ JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />b-'l9'o 91-A
<br />I
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<br />- SUBDIVISION
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<br />c5/", ;z. (hl)/~~ lit 355~c:2- LOT #
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<br />I PARCELlD#1 \, - a<:a -a\_ty')\O-63500- 6\3(:)
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR rXl AD DIAL T D SIGN D MOVE D
<br />D INSTALL D REPAIR
<br />PROPOSED USE 159 SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK 15 l,L) \ nA h. Il ~ d 9.. d O~
<br />
<br />BUILDING SIZE SQ FOOTAGE I I HEIGHT I
<br />111111111111111111"111'11111111111111111111111111111111111111'111111111111111111111111'111111111111111111111111"1111111111111'111111111111111111
<br />rXO BUILDING 1$ .
<br />. \ 500,00 I VALUATION OF TOTAL CONSTRUCTION
<br />
<br />o ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNo
<br />
<br />1111111111111I11111I11111111111111111111111111111I1111IIIIIIIIIII~IIIIII~IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111111111111111111',
<br />
<br />~UILDER 00f~ L " 0 "COMPANY ~ t-~ CJLsl-.'Y\SU-- I
<br />SIGNATURE REGISTERED I Y 1 N I FEE CURRENT Y 1 N
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<br />WORK PROPOSED
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<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br /> License #
<br />Y 1 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 />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />license #
<br />I111I111I11111111111I1111111111I111111111111111I11111I1I11111I111111I111111111111111111111111111111111111111II11111111111111I11111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 wI 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 />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)
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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 (PloUSurvey/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 roadwaysooneeds ROW
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<br />)/O('yJ( DUJ!1f' (5 '(f' Yf>l t +-
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