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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
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<br />
<br />
<br />Owner's Name
<br />
<br />Jl
<br />1911:1 ,St. ZCPty'h'llS, F I
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<br />Own._. Add,... 15=1 T
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<br />
<br />Fee Simple Titleholder Name
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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 />Fee Simple Titleholder Address I
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<br />~ 2ftJf?ljrhiLl5 J Fl. 3~~42 I LOT#_I
<br />I I PARcELlD#III-lli-21-(;t)tD--041CO-QO\O
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR D ADD/ALT 0 SIGN D MOVE 0
<br />D INSTALL D REPAIR
<br />PROPOSED USE 0 SFR D COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
<br />
<br />DESCRIPTION OF WORK [[Cp1ClfJn9 qJ,iQqL ~y
<br />
<br />BUILDING SIZE I SQ FOOTA~E I HEIGHT
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<br />0"'" ~~::~;~~""".., i~'~ 5'0'.' 'Q~'" ~"" '~~~~~:~~ '~~ ~~~~~ '~~~~~~~~~,~:"""""""""""""""""""'" ,
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<br />D ELECTRICAL 1$ / I
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<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'111111111I11II1111111111111II1111I1111I1111I11111111111I11111111II1111111111111111II11111111111111111
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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 />AMP SERVICE
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />o
<br />
<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION
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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 wI 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 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~~~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 $5000)
<br />
<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
<br />
<br />Address
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<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
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<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
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<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />OTHE
<br />SIGNA
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<br />RESIDENTIAL
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<br />COMMERCIAL
<br />
<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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<br />Y/N FEE CURRENT
<br /> License #
<br />YIN FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br />
<br />YIN
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
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<br />License # I
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<br />13r\/~~lr~$NT ~~ IIDt.
<br />License # I f1 nr (jq{) 84
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