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<br />813-780-0020
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<br />Date Received
<br />
<br />Owner's Name
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Owner's Address I if ff'Z %
<br />Fee Simple Titleholder Namel
<br />
<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 />Fee Simple Titleholder Address I
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<br />Cf!z.-<g
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />
<br />
<br />B
<br />D
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<br />SQ FOOTAGE I J :S' ~ ~
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<br />LOT #
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<br />f4.-U-<J.I-o - 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D SIGN D MOVE D DEMOLISH
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<br />D OTHER I
<br />D STEEL D OTHER I
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<br />ADD/AL T
<br />REPAIR
<br />COMM
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />HEIGHT I
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />111 . III , 'II 111 , , 1111 , , , . III , , I III r . . I 1111 , .. I II , 111 , ~ IIII , I I 111111111 . . . I11II , , III . . III , 1111 , 11111 , 1111111111 , 1111 , . III1 . III , I . 1111111 " , I 111 ,. III
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<br />1$ 1S"60p dLJ
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<br />1$
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<br />1$
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<br />1$
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<br />DGAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />~~~~~RE I "e ~ I ~~~::~~ I f?;,~~O':~R,.1*'N I
<br />Address I Y:5/7 uJ v 'D-E13DR;J AU 7~,o.l1) rL License # ICGL:-(Z)"t>Z3 7671
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<br />ELECTRICIAN I I COMPANY I I
<br />SIGNATURE . REGISTERED Y / N FEE CURRENT Y / N
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<br />Address I License # I
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<br />:~::~~E I ~~~r;:.~~ Y I N FEE CURRENT Y I N I
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<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
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<br />Address
<br />
<br />ROOFING
<br />
<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
<br />
<br />DNO
<br />
<br />D
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<br />D
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<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
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<br />AMP SERVICE
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
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<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />1111I111I1111111111111111111111111111111111I111111111I111111111111I111II11111111111II111111111II11111111I1111111111111111111111111
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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 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 />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Dl~~~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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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