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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />
<br />- Owner's Name l~ ~ '5
<br />Owner'sAddress I lJ73'?- 2. r~ ~ Z-//{j//:;s-;::Z
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />
<br />- JOB ADDRESS
<br />
<br />l)73S- ~ r~ 5/
<br />
<br />LOT#
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />El
<br />D
<br />D
<br />
<br />PARCELlD#1 / / - ;;/ 6 - :J, j- 0 tJ 10 - (J 3> -got) (!}O 10
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />SUBDIVISION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />
<br />I
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<br />
<br />5lJ #&A"I' (/ L::- .71 :2tJ'sot.//
<br />HEIGHT I
<br />
<br />BUILDING SIZE
<br />
<br />"'0
<br />
<br />o
<br />o
<br />o
<br />
<br />1$ /DOa&D
<br />
<br />1$ 11/4-
<br />
<br />1$ ///J.
<br />
<br />1$ A4
<br />o GAS 0 ROOFING
<br />FINISHED FLOOR ELEVATIONS 11//4
<br />
<br />I
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<br />I
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<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 0 OTHER
<br />
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />I I I , , I I I I r , I , . , I I ~ . I , . . . I I I It' I , , I I . I I . . . . P I I I . I . I . I I . I I . I I I , I , , I , I . I I . . I I I , , , , , , . . , , , I , , r I I , . I . I I I , r I I , . . , . . . I I I , , , , . p . I I I I , I . , . I , I I I I I I 1 I r , , I . . .
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<br />e BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />If~~ fW~~~RRENT
<br />Y/N
<br /> License # I
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNA lURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />111111111111111 1111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />COMMERCIAL Attach (3) complete sets of Building Plans plus a Life Safety Page; (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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />1I11I11111111111111111111111I11111I111I111111111111I11111111111111I11111111111111111111111I111111111111111I111I11111111111111111111111111111111111
<br />Directions:
<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 AlC Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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