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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />f160J
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<br />Fax-813-780-0021
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<br />Owner's Name
<br />
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<br />,a t- ThOM
<br />1G,~3,) JiAV\I'p(.v L+-
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<br />
<br />Date Received
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
<br />1",,3, JlA\i\l't't-\' Cf
<br />I
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<br />BLOCK
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<br />""2~pk'1L"\",'IIS F ( 3351& LOT #
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<br />I PARCELlD#!02--2-(., - 2..1 ~Dz..,o-oOOOO- 12.30
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />E3 ADD/ALT D SIGN D MOVE D
<br />REPAIR
<br />D COMM D
<br />D FRAME D
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />.'..11...11.'....111.......11...11...........11..........11...'11...............,..'.....111.....11.........111111.......11111.............11.111.
<br />
<br />B
<br />D
<br />D
<br />~(.. VO 0 f
<br />I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />
<br />DEMOLISH
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER
<br />STEEL
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<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />BUILDING SIZE
<br />
<br />
<br />'v\A-b(vl (''^""^'
<br />HEIGHT I
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<br />DESCRIPTION OF WORK
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<br />D BUILDING 1$ 5000 I ()0 I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D W,R.E,C
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION
<br />D GAS m ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />I , I . . , , , . . . I I I . I I I . I I I , P , I I I , I I I I , , I , 1 . ~ . I I I , . . . I I I I . . I . pI. 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 , , . . . t , . . . , . , . . , . . . . . .
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<br />BUILDER
<br />SIGNATURE
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />PLUMBER
<br />SIGNATURE
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<br />Y/N
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<br />FEE CURRENT
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<br />Y/N
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<br />Address
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<br />License #
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<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
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<br />License # I
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<br />COMPANY I 5, SCo...ckhC{ v--. teCtuft'~ii
<br />REGISTERED I Y / N I FEE CURRENT I Y / I
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<br />License # I (. ceO r;; 7 7' ) 7
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<br />Address
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<br />~~NE:rURE L&~~
<br />Address I ~ '3 u l D 5Y- S:L r 0 6 c. K. t \ W
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<br />1111II11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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) 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 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 />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I
<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
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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