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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />So w A
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<br />Z<:.-~}I'I/l JI/ll-f I LOT# 133/-;1'/ I
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<br />PARCEL ID#I '2. t- ~- U "'OO2AJ.;'" Oo10lJ /' 031 ( I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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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 Address I ., 9 D 1.- 0
<br />Fee Simple Titleholder Namel
<br />
<br />Owner's Name
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<br />/f"'A!L
<br />
<br />Fee Simple Titleholder Address
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<br />SUBDIVISION
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<br />cyril
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<br />JOB ADDRESS
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION 00
<br />DESCRIPTION OF WORK I ~ ~ C M A ~ /J ) T j tJ /f..-'
<br />BUILDING SIZE lL,f~X /7 i 'I .. sa FOOTAGE I 2-S 5" tP HEIGHT I
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<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />IKI
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<br />1$ 2tl CI 0 , 00 I
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<br />rn ELECTRICAL r 1;0, () 0 I
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<br />D PLUMBING 1$./1/}7 I
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<br />D MECHANICAL 1$ fOo, cO I
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<br />D GAS CXI ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES liD NO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<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 />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />/WM-fL Ot.,.~
<br />I Y IN I FEE CURRENT
<br /> License #
<br /> ~/'I~ O~
<br />I Y I N I FEE CURRENT
<br /> License #
<br /> YI N FEE CURRENT
<br /> License #
<br /> Y/N FEE CURRENT
<br /> License #
<br /> Y/N FEE CURRENT
<br />
<br />Y/N
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<br />BUILDER
<br />SIGNATURE
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<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />~
<br />
<br />;I~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
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<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 />5M' ..."rI~
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
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<br />License #
<br />11111111111I111111111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111
<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 />Di~~~ti~~~': ' , , . . . . , , . . . , , , , , , . . , , , . , . , , , , . , , , , , , , , , , , , . , , . , . , , , , . , , , I . , . , . . . . , , , . I . , , I I , . , . , . , , , , , , I , , , , , , , , , , , , , , , , , , , , , , , . , . . . , . , , , , . I , , . , . , I , . I
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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 (PloUSurvey/Footage)
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<br />Address
<br />111111111111111
<br />RESIDENTIAL
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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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