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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-78o-0021
<br />
<br />Date Received
<br />
<br />
<br />Owner Phone Number J?/3-
<br />
<br />r Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />OWner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />57~"\G ("~VI": 7'; - ~7
<br />JOB ADDRESS . ~d '3
<br />
<br />SUBDIVISION [
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />CR. sy~ ~!i'~M
<br />
<br />I PARCEL ID#
<br />
<br />B
<br />D
<br />D
<br />
<br />17-
<br />
<br />lOT #
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />B
<br />D
<br />D
<br />I
<br />
<br />D
<br />D
<br />D
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />OTHER
<br />STEEL
<br />
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT I
<br />Tnlll'I"'IIIIIIIIIIIIIIII'l"'I"'.IIIIIIIIIII'111111111111111111111111"'111111111111111'111'11111111111"1"'1'1"""1"""'11'11'11'11111111
<br />
<br />D BUILDING 1$ J 0, 0 DO . I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D 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 />11I11111111111111111I111111111I1111111I11111I1111I11111I1111I11111I11111111111I11I1I1111II1111I111111111II111III1I1II1111I1111I1I111111111II11I11I
<br />
<br />:~~~RE I ~ f7/~ ~'i ::e"rn~~"= ~1~"~.;)~]~Tvlc-1
<br />Address I 0~ t3 Ilotn st-
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />f.joC -
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />
<br />Jt~OO()'? S;:7o
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />L-
<br />
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />Address License #
<br />111111I111I111I111111111I1111I1111I11111111111111111I111111111111111111111111111I11I11111111111111111111111111111111111111111111111111111111111111
<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 onslte, Construction Plans, Stormwater Plans wI 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 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 />SIGN PERMIT
<br />
<br />Di~~~tj~~~': ' , , , , , , , , , . , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , , . , , , . . , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , . . , , , , . , , , , , , , , , , , . , , , , , . , , , ' . , , , , . ,
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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