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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
<br />
<br />
<br />
<br />11(0
<br />
<br />Owner's Name L , . c..... .
<br />
<br />Owner's Address lo'5'5~ LAO" "D<.. Zeph4,h.\b. F'L.
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />l.o to 0\.0
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<br />JOB ADDRESS
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<br />G-A-u
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<br />&\)<1.
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<br />7--e.ph"td',,\b l=L. 3'~~~ LOT #
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<br />PARCELID#I O~ '~,*" ~l . OO\C .aSl",ca. CCYl-C
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />SQ FOOTAGE I I HEIGHT I I
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<br />ADD/ALT
<br />REPAIR
<br />COMM
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<br />D
<br />o
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<br />DEMOLISH
<br />
<br />SUBDIVISION
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />D
<br />
<br />III , 1111 , 11111 , , III' , , I 1111 . , ' , III II' I , III' , 1111' , 11111 " 1111111 ' I1111 ' , , III . , 1111111 .. , , 111111 rl , 11111 . 111111' " II , 11111 I , 11111111111111111111111
<br />
<br />1$ I
<br />1$ 501). 00 I
<br />
<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 />1111111111111111I1111I11111I1111111111111111111111111111II1I111111111111111111111111111I111111111111111111111111111111111111111111111111I11111I111
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />100
<br />
<br />IXJ
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />YIN
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<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address
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<br />ELECTRICIAN.k, , rr--r 1 , AI COMPANY
<br />SIGNATURE D~ \il~ . REGISTERED
<br />Address I -p O~ <l-~ ~~,\\... K.. ~<;'Y1' ~IC'~I
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<br />:~:A~~E I I ~~~~:
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<br />License #
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<br />R-L~~ U~u:...\ . 'hi L..-
<br />IlY} N I FEE CURRENT I C!j N
<br />
<br />License # /I '-t-~ '1
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />YIN
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<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 />
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I111111111111
<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~~~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)
<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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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