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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />11"'11"11
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel h.( It
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I rl 10
<br />
<br />I 59 l./ J
<br />I
<br />
<br />!7~ ~d-
<br />
<br />LOT #
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I PARCELlD#1
<br />B AD DIAL T D
<br />REPAIR
<br />D COMM D
<br />D FRAME D
<br /> /l.A. <-/l, 0 0
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />DESCRIPTION OF WORK
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />7A#-
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE
<br />
<br />D BUILDING 1$ 00 I VALUATION OF TOTAL CONSTRUCTION
<br />3r DOD.
<br />0 ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY 0 W.R.E.C,
<br />0 PLUMBING 1$ I
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />0 GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />COMPANY 1?cu.J
<br />REGISTERED I Y I N
<br />
<br />Llrf
<br />
<br />.335"' /
<br />COMPANY I
<br />REGISTERED
<br />
<br />fC~NT~~ I
<br />
<br />License # I L CC 0 5f{ /3 t/
<br />,
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<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 />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address License #
<br />111111111111111111111111111111111111111I1111111111111111II111111111I1111111111111111111111111111111111I111111111111111111111111111I111II1111111111
<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/Jarge 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 />Di~~~ii~~~': ' , . . , , , , . , . , . . " , , . . , , , . . , , , . . . , , , , , . . , , , . . , , , . . . . . . . , , , . . . , , . . . . . , , , , . , , , . . . , . . . . . . , , , . . . . , , , , , . , , . . . . , . . , , , . , . . . , . . , . . , , . , , . , , , , , , , , . ,
<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 AlC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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