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<br />
<br />8'13-780-0020
<br />
<br />Date Received
<br />
<br />........1..
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee SimplE! Titleholder Namel
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Owner Phone Number
<br />
<br />OWner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />15F'3t) I;resr
<br />I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />2e;/lh'1-< (eLLS ~ I LOT# I
<br />
<br />PARCELlD#II/- 2 & -;;2. (-Ov/()-0360 -tJo/l?1
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />I
<br />
<br />E3 ADD/ALl D
<br />REPAIR
<br />D COMM D
<br />D FRAME D
<br />Il2dUrt.. (?fJ ftC- L( tJ \ T.. (-Z ~ O~ ")
<br />
<br />SQFOOTAGEII{}(JO sq 'f:-r I
<br />
<br />~
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE
<br />
<br />
<br />HEIGHT
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$3oCO~ I
<br />f
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'1111111111111I11111111111111I111111111111111111I1111I1111111111111111111111111111I1111I11111111111I11
<br />
<br />0 BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />QQ MECHANICAL
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATUR,E
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License # I
<br />
<br />MECH~ /~/ /? COMPANY 177c,""/s If:f..f- ~ Ht-'C-
<br />SIGNA~~~ REGISTERED r---L1"?"/'N I FEtCURRENT( I Y/N I
<br />
<br />Address I /(/1( 4M.JddlJ dr A' "7 elf r /,f- (t 133bf +.. License # Ie /?'tC- c) 50 7'';-C
<br />
<br />OTHER COMPANY I
<br />SIGNATURE REGISTERED Y I N FEE CURRENT Y IN
<br />
<br />Address I I License #
<br />11111111111111I11111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvisionsllarge 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~~~ti~~~': ' . , , , , . , , , , , , , , . , , , . , , , , . . , , . . , . , , , , . , , , , , , , , , . , , , , , , , , , , , , , , , , , . , , , . . , , . , . , , , , . , , , . . , , , , , , . , . , , . . . , , , . , , . . . . , , . , . , . . . . . . . . . . . . , . , . , , . .
<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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