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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 />
<br />1\-20-6
<br />
<br />Owner's Name 5 ~ct, '(Y\ L.."-~
<br />Owner's Address I {,.3. l.s ~t' ~- e.r- Dr.
<br />Fee Simple Titleholder Namel
<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 />138 'f~tl
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<br />~c.f~/38t../,;81 SJ't.f3 C>
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<br />I PARCELlD#II(-..2k -:"t/ -~!>(O - fG? 700 -O.:J..t D
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />~ ADD/ALT
<br />D REPAIR
<br />D COMM
<br />D FRAME
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<br />WORK PROPOSED
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<br />I SQ FOOTAGE I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />1$ .3/, q /,--13
<br />
<br />1$
<br />
<br />D PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />LOT #
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<br />D
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<br />HEIGHT I
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />BUILDING
<br />
<br />~ ELECTRICAL
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<br />I," tS>OrCC)
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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
<br />
<br />License #
<br />1111111111111I111111111111I1111I11111I11111111II1111111I111111I111111111I111I1111111111111111111I1I11111I11II111111111111111111I11
<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 w/ 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 onsite, 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.
<br />
<br />D
<br />I
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />ROOFING
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />OTHER
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<br />I' 'm" N I FEE CURRENT I Y~ I
<br />License # Ic..~ e I ;"c0915P I
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<br />License # 1~C-/50DI3tf3 I
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<br />Y / N
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<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />DI~~~ti~~~':' , , . , , , , . , I , , , , , , , . . . , . , , I , , . , I , . , , , . , I , , , , , , , , . , , , . I . , . , , , , , , , , , , , . , , . I , . , , , , , , , , , . , . . . . I , . , , , , . . , . . . . , , . , , , , , , . . , . I . , . . . . . , . . , . . . . . . ,
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<br />Fill out application completely.
<br />Ownelf & 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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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