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<br />813-780-0020
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />l\ ~ \C{ -67
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Owner Phone Number
<br />
<br />h ( hilts FL B 5" tfJiwner Phone Number I
<br />OWner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />DEMOLISH
<br />
<br />~
<br />~
<br />~
<br />~
<br />
<br />B
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />etlyO c1 e.I
<br />
<br />BUILDING SIZE I 30 ()< <? 0 I I
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<br />1$ ;<5,000, Q9-
<br />/
<br />1$
<br />
<br />1$
<br />
<br />1$
<br />
<br />c=J GAS D
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />
<br />OTHER I
<br />
<br />ROOFING
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />NOl~ ~ro
<br />~1 fY\ - Sex->~ \ \ I zo 107
<br />
<br />W.R.E.C.
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />Address
<br />
<br />
<br />FEE CURRENT
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />I eFt. 14- J..b 1/ g
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License #
<br />I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111
<br />RESIDENTIAL 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 />COMMERCIAL 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />Di~~~t;~~~': ' , , , , , , , , , , , . , , , . , , . , , , , . , , , , , . , . . , , , . , . . . . . , , , , , , . , , , , , , , , , , , . . . , , . , . , . , , . . . , . . , . . . , , , , , , , . . . . . , , , , . , . . . . , , . , . . . . . , , , , , , , , . , , , , , , , , , . .
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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)
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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