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<br />813-780-0020
<br />
<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
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<br />Owner Phone Number I
<br />
<br />788.0:311
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<br />Owner's Name . Be ' le:f-cY\
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<br />Owner's Address 110 00 <;; 11* S r 'Ztfh 'I riLL {Is
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS I (p DO S { I -h, s- (
<br />
<br />I 7Cr s (rr.
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D BLOCK
<br />
<br />DESCRIPTION OF WORK I R..r, r 6tJ:.f
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<br />LOT #
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<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />
<br />I PARCEL ID#16;;).
<br />E3 ADD/AL T D
<br />REPAIR
<br />D COMM D
<br />D FRAME D
<br />
<br />SUBDIVISION
<br />
<br />:2L. -d 1- 6tJ!O . 66/00 . 0130
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE D DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT I
<br />""'1"1"1'11111111111"11111111111111111"'1'11"'11111111"'111'111111111111"111111111"1'1111"11111111111111111"'1111111111111'11111111111
<br />
<br />1$ I
<br />. ;J()OD (Xl
<br />
<br />1$ I
<br />1$ I
<br />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 />11I111111111111111111111111111111I111111111111I1111111111111II11111111111111111111111111111I11111111111111111I111111111111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />&0.
<br />
<br />~~/+ey,
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~.~
<br />I Y / N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<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 />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 />MECHANICAL
<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 />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />1"111"1"""
<br />RESIDENTIAL
<br />
<br />License #
<br />111111I111111111111111111111111111111111111111111111111I111111I11111111111111111I111111111111111I1111111111111111111111111111I1111
<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 w/ Sill 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 />COMMERCiAL
<br />
<br />SIGN PERMIT
<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)
<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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