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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received ~ _ I I - (:)7
<br />. G',o,.,PJ/> i'1 c. f"'SeC:Rfl/f-
<br />/ Owner's Name ~......v~ I,... c::; (y
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<br />( Owner's Address I 6';) '5 S- / Y d: Sf- .
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
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<br />Owner Phone Number I
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<br />Owner Phone Number I
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<br />"JOB ADDRESS
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<br />SdSS
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<br />Fee Simple Titleholder Address
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<br />B
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
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<br />/DESCRIPTION OF WORK I 'M Roc~
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<br />I I
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<br />1111111'1.1'11111111'111111"111111111'111'...'11,11111,1111'IIIIIIII'lllt"IIIIIII"ltt'IIII'llt,IIII,lrlll11111111"1',"111111111'1'11'1'11111'.
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<br />/ 1$ .rJ ^ kA.. D^ ".. I VALUATION OF TOTAL CONSTRUCTION
<br />. c;f-Uuv- u 10' )l'Iu'~ f-.JOC-
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY
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<br />D PI~UMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />1111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111
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<br />I PARCELlD#1
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<br />B
<br />D
<br />D
<br />S'J/ ';tJ7/e~
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<br />SQ FOOTAGE I
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />BUILDING SIZE
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<br />D
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<br />BUILDING
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<br />LOT #
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<br />\ \ - 2(.;,- L\ - 00\0 - li<60D. 0050
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />o
<br />D
<br />o
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<br />DEMOLISH
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<br />I
<br />D
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />HEIGHT I
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
<br />111I111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111I1111111111I111111111111111111111111
<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.
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<br />BUILDER /
<br />SIGNATURE
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<br />
<br />/"
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<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE
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<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
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<br />I
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<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />!J()'ry\e oum} e V
<br />I Y / N I FEE CURRENT
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<br />Y/N
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<br />License #
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<br />Y/N
<br />
<br />Y/N
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<br />FEE CURRENT
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<br />License #
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<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y / N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
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<br />License #
<br />
<br />Y/N
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<br />Y/N
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<br />FEE CURRENT
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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)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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