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<br />8',13-780-0020
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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 />own~.r's Name
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<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 />Date Recleived
<br />:c:mn::
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS
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<br />So0-~ ~~
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<br />?f1 f;Ll
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<br />LOT #
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<br />SUBDIVISION I PARCELlD#1
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED Er' NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR c:::B-"" COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME 0 STEEL D OTHER I
<br />DESCRIPTION OF WORK I \...U \. tZ. \ If--- r 0 F- tV~ uJ -;=0-t.- L fJ~~f1S
<br />BUILDING SIZE I sa FOOTAGE I I HEIGHT I
<br />
<br />IIII.I,llr"111111111111111111111'IIIIIIIIIIIIIIIIIII'11111111111111"1111111111'1111"111'1'111"1111"1'111'1111111111'11111"111'1'111111111111
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<br />~ELECTRICAL
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<br />1$ I
<br />1$ I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
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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!IIIIIIIII11111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />WR.E.C.
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<br />D
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />COMPANY
<br />REGISTERED
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<br />BUILDER
<br />SIGNATURE
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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 />ELECTRICIAN
<br />SIGNATURE
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<br />
<br />,
<br />~~
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<br />/ <to ~ c.v !e-/Yl ~ CE
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<br />Address
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<br />License #
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<br />Address
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<br />License #
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<br />pF~666/~t:J
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<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />MECHANICAL I
<br />SIGNATURE
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<br />Address I
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<br />OTHER I
<br />SIGNATURE
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<br />Address I License #
<br />111I1111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111I1111111111111111I1111111111I1
<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 onsile, 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 onsile, 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 />License #
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<br />COMPANY
<br />REGiSTERED
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<br />Y I N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
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<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Di~~~ti~~~':' . . . . , , , . , , . , . , . . , , , . . , . , . . , , , . . . . . . . . . . , . . . . , . . . , . . . . . , , . . . , , , . . . . . , , , , , . , , . . . . , , , , . . , , , . . . . . , . . , , , . , , . . . . , , , , . . . . . . . . . . . . , . , . . . . . , . . .
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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 NC Fences (Plol/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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