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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 />Date 'Receive~
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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 />Owner's Name fSuns7.#c
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<br />Owner's Address Sit t'1 17 n fm/t>
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS :)-71/0 7Ht SI. 2~fk,rA,i/f F/ 33:;-'11 LOT #
<br />SUBDIVISION I PARCEL 10#1 / /- .;1.(.,. - PI. I - ad IlJ - o..zr;oo ~ ~ ( 3 t1
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED B NEW CONSTR B ADD/AL T 0 SIGN D MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
<br />DESCRIPTION OF WORK ;?~mpt/e ..;z ;::/"'<7, / ~i-'~ / dt:.-< f /~ 1--. <,{l" -1-7 {, e <- ~ 2 rll'd I'!~ l'Cr prt" J
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT
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<br />D
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<br />-rTfTTTrrTrJ III.'" 1111'1111." t 1111'111 r 1'11.' III" III.' 1111..'" 1111' 11111'11111'1111111111111" 1'111'111." III" III1III t, III.. r III1IIIII1 r. II1II
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<br />BUILDING
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<br />1$
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<br />I
<br />00 ELECTRICAL l~eRl ~,p I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />1111I111111111111111111111111111111111111111 , 111111111111111111111111111I1111111I111I111111111111111111111 rill II III 11111 11111 11111 11111 11111 11111 I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />Address
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<br />A 1ft;' ;eel
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<br />r.J,,7!~ PI.
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<br />I
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<br />
<br />License #
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<br />~-I-'h~ C;-/cclr/~ ,'~~{"n'j""t;l.f/~
<br />Y / N FEE CURRENT Y / N
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<br />1It?l3? - License # k-e - ~~t11 Zt"H-
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />~~~
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<br />
<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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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 />
<br />Y/N
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<br />Address
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<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/NI
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<br />Address
<br />11/111/11/1/11/
<br />RESIDENTIAL
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<br />1111111111111111111111I1111111I1111111111I1111111111111111II1111111111111111111111111111111111111111111111111111111I11111111111111
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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 w/ 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 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.
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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 NC Fences (Plot/Survey/Footage)
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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