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<br />813-780-0020
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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 />Owner's Name
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<br />Owner's Address I 3 f") 7/0
<br />Fee Simple Titleholder Namel
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<br />
<br />-07
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<br />Date Received
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<br />Fee Simple Titleholder Address I
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<br />377/0
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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 />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />I LOT# I
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<br />03-2.0 - 2( - 01 30 _o(X)OO-030eJ I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />DESCRIPTION OF WORK
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<br />BUILDING SIZE I I sa FOOTAGE I I HEIGHT I I
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<br />o BUILDING 1$
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<br />o ELECTRICAL 1$
<br />o PLUMBING 1$
<br />o MECHANICAL 1$
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<br />o GAS 0 ROOFING 0 SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/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 /> License #
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<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 />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />II111111111111 1111111111111111I1111111111111111111111111I11111111111I111111111111111111111111111111111111111II1111111111II11111111111111111111111
<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 (1 O) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />Dl~~~~i~~~':' , , , . , , . . , . , , . , , , , , , , , , , . , , , , , , , , , , , , . , , , , . , . , . , , , , . , , , , . . , , , , , , , , , , , , , , , , . , . . . , , , , , , , , , , , , , . . . , . , . , , , , , , , . . . , . , , , , , , , , , , , , , , , , , , , , , , , ,
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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. (A1C 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 A1C Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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