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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />Owner's Name
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<br />?C/C;'
<br />Owner's Address 0
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<br />Fee Simple Titleholder Namel
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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 />Fee Simple Titleholder Address
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<br />/ ,JOB ADDRESS
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<br />3.g C( (c(
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<br />( { tit d- v("
<br />
<br />I
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<br />D NEW CONSTR n
<br />D INSTALL D
<br />PROPOSED USE D SFR D
<br />TYPE OF CONSTRUCTION D BLOCK D
<br />
<br />;' DESCRIPTION OF WORK I5+DfO--%<- sne.c1
<br />
<br />,. BUILDING SIZE I / () >( (;A I SQ FOOTAGE I I HEIGHT I I
<br />III'III"II'I'II'III'II:I~I~"~IIIIII'III"'IIIIIIIIII11'11"111""111'1111'111'111111111"111'11'111"111'11111"11'11111111111111111111'1111
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />LOT #
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<br />PARCELlD#1
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<br />i\-2~- Z-\- 00\6 -l')O-,OD- 0\00
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />I 1$ ~ b 00
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<br />1$
<br />
<br />1$
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<br />1$
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<br />c=J GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />BUILDING
<br />
<br />c=J ELECTRICAL
<br />c=J PLUMBING
<br />c=J MECHANICAL
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<br />ROOFING
<br />
<br />BUILDER
<br />SIGNATURE
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<br />
<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE
<br />
<br />Address I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />o
<br />
<br />W.R.E.C.
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<br />PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />DYES
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<br />ONO
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<br />
<br />COMPANY
<br />REGISTERED
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<br />~YniLc..>u-;~
<br />I Y I N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<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 />License #
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<br />III 1111111111111111111111111111111111111111111111111111111I111111111111111111I111111111111111111111111111111111111II1I11I111111111
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<br />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 subdivisionsllarge 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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Di~~~ii~~~':' . . , , . . . . , . . . , , . . . , , . . . , , . . . , . . , , . . . . , . . . . , , . . , , . . . , , . . . , , . , . . . . , , . , . , . . . , . , . , , . . . . , , . . , . , . . . , . . . . . . . . . , . . . . , . . . . . . . . . , . . . . . . . . . . . . . . . .
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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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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