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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 />,5"'-M e....
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />
<br />T ~"I~ Ave....
<br />I PARCEL 10#1
<br />
<br />B
<br />o
<br />o
<br />
<br />JOB ADDRESS
<br />
<br />3 f) I (J""D
<br />
<br />LOT #
<br />
<br />WORK PROPOSED
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />3';-- (l-'T - Cl-I- (JT) I 0 - 0'6 1(1)- fTD / 0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />DEMOLISH
<br />
<br />SUBDIVISION
<br />
<br />@
<br />
<br />PROPOSED USE 0
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK . NS tz,-.. / } 5' -tc> (L.-C- t..
<br />
<br />BUILDING SIZE I{ ?-7<'~ 't I SQ FOOTAGE ;z... g i HEIGHT I 8 I' I
<br />
<br />1'.II..II....IIII....II~~...r..:.I.I..,..II...,II....,...11...1111...,11.....11,........1111......,11.............,...........111..,....,.......
<br />
<br />~ BUILDING 1$ 't, vrro I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE 0 PROGRESS ENERGY
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />
<br />D GAS 0 ROOFING 0
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />o
<br />o
<br />o
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />~
<br />
<br />OTHER
<br />
<br />
<br />o
<br />
<br />W,R.E.C
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Not;
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />DYES
<br />
<br />ONO
<br />
<br />I I I I ~ , I I , . I I I , I . . I 1 , I . . , I I . I I I . I , I I , r . . I , I 1 . . I , , I . . I I I I I . , , I 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 , I I I I , I . , , I I I I r I I 1 I . I I r I
<br />
<br />~~~~~~RE I ~~ .. ~ 7'~ ..r-
<br />
<br />Address I 3'31 leJ- T ~ V; 'l..vif Au L
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />Address I
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />(l.~~ P~~b ~
<br />I Y N I E CURRENT
<br />
<br />License #
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br /> FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />111111111111111 11I1111111111111111111111111111111111111111111111111111II1I11111I11111111111111111111111111111111111111111111111111111111111111111
<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 />111I11I111111111111111111111111111111111111111111111111I1111111111111111111111I11111111111111111111111111111II1111111111111111I1111111111111111111
<br />Directions:
<br />Fill out applicalion 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 Ale Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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