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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 Received
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<br />Owner Phone Number~ ) 'S - 8':> ~ - S
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<br />Owner Phone Number I q /)
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<br />Owner Phone Number I
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<br />Owner's Name
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<br />. \e
<br />Owner's Address ) J
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<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />1-s<J> \S
<br />I
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<br />SO"-\\' Avt.
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<br />LOT #
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />1
<br />B
<br />D
<br />D
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<br />PARCELlD#1 \'....2(,.2.1 - 60\0-. I~~OC:> ~ IL~o5b
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
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<br />SUBDIVISION
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<br />WORK PROPOSED c=J
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<br />PROPOSED USE ~
<br />TYPE OF CONSTRUCTION IZI
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<br />DESCRIPTION OF WORK 10---(-00\ 30- 9)\~lr....D
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<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />D
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<br />OTHER I
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<br />1$ { roOD, 0-0 1
<br />1$ I
<br />1$ I
<br />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
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<br />1I11II111III III L>>llltIlIUtl'l III~ 111I1111I111 1 II 1 111I 1 1 1 111111I1111I 1 1 1 III 1 I11II 1 1111I111II11111I111111I1 1 1 1111111I1 1 1 111II1 1 1 1111111111111111111
<br />
<br />, BUILDER " L i ;~ .) ! j.,:) . -- { _'.. ., COMPANY I ~~ I
<br />SIGNATURE . -~ II / ~. L L L. L ' . REGISTERED I Y / N I FEE CURRENT Y / N
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<br />~
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<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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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.RE.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address
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<br />\i -c:.
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<br />License #
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<br />ELECTRICIAN
<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 />Y/N FEE CURRENT
<br />
<br />Y/N
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />License #
<br />111I111111111II1111I111II11111111111I111I1111111111111I11I1111I111II11111II1111I1111111I1111111111II11111III111111111111111111111I
<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 on site, 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 />Di~~~ti~~~':' , . . , , . . , . , , . . . , , , , , , , , , , , , , , , , , . , , , , , , , , , , , , , , , , , , . . , . . , . , , , , , , , . . , , , . , , , . , , . , , , , , , , , , , . , , , , , , , , , , , . , , , , . . , , . . . . . . , . . . , , . , , . , , . , , . , , . .
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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 />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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