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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />Date Received
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<br />Owner's Name
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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
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<br />I Silwur ili-ks
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<br />PROPOSED USE 0
<br />TYPE OF CONSTRUCTION 0
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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 />I LOT# I
<br />PARCEL ID#I 0 8- ~0 -~ 1- 0 1').0 -00000 - 105/
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
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<br />1$
<br />1$
<br />1$
<br />1$ 1550.00
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<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111111111111111111111111111111111111111'111111111111111111111111I111111111111I111111111I1111I11111I11I111111111II1111111111111111111111111111
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<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />[Xl
<br />D
<br />D
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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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 />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />LA] MECHANICAL
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<br />DEMOLISH
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<br />VALUATION OF TOTAL CONSTRUCTIOa.iL ?JD}_
<br />AMP SERVICE D pr~Y
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />Address License #
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<br />1111111111111111111111111111111111111111111111111111111I11111111111111I11111I1111111111111111111111I11111111I111111111111111111I111111111111111111
<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 />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 />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
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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
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<br />COMPANY
<br />REGISTERED
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<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
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<br />
<br />Address
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<br />OTHER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />COMMERCIAL
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<br />SIGN PERMIT
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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 />License #
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<br />Y/N
<br />
<br />Y/N
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<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License # I
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<br />mY ,'S ) Ale" 0J rvtJJfL.I1l J
<br />I .......j v~ / N I FEE CURRENT I I Y I Nil
<br />License # I CAe 0 5 E?5 '7 5"
<br />
<br />Y/ N
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<br />Y/N
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<br />FEE CURRENT
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<br />DI~~~t;~~~': . . , , , . . , , , . . , , , . , , . , . , , , . . . , . , . . , , , . . . , , . . , , , . . . , , . . , , , . . , , , . . . . . , , . . , , , . . . , . , . . , , , . . , , , . . , . . , , , , , , , . . . . , , , , . , . . , . . , , , , , , , , , , , , , , , , , , . ,
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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)
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<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)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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