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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 />
<br />Date Received
<br />
<br />
<br />Owner's Name i~ U SSE L L. J.
<br />Owner's Address 13 g Lf 8..3 9 f/t..,
<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 />
<br />13g-4~ 3.
<br />I
<br />
<br />Cjt!-
<br />
<br />IQJ/~ I LOT # I
<br />I PARCEL ID#I II Z& z / tJ()jtJ /J37M 011 ()
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />51 AD DIAL T D SIGN D MOVE D DEMOLISH
<br />REPAIR
<br />0 COMM D OTHER I
<br />0 FRAME D STEEL D OTHER I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />ro
<br />D
<br />I
<br />
<br />/ ~O 01.">\ P
<br />HEIGHT I
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />DESCRIPTION OF WORK
<br />
<br />Setf tJ; '- ~ Ll~,rd\.J ..sL.
<br />SQ FOOTAGE 1
<br />
<br />BUILDING SIZE
<br />
<br />TTTlTI 111111111 . 1111 , ' , II I ' 111111111 ' 1111111 11111111 , '1111 'II" 11111111 ' , 1111 , 11111111111 . I1I11111 ' 1111 ' , II " I111 ' II ' 11I1111 ' , 1111111 , .. III ' III ' I
<br />
<br />1$
<br />
<br />1$ 7oa. ~
<br />
<br />D PLUMBING 1$
<br />
<br />D MECHANICAL 1$
<br />
<br />D GAS D ROOFING 0 SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />/~O o.""F
<br />
<br />~
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />PROGRESS ENERGY
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />11111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 />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.
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br />
<br />/7
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />DI~~~ti~~~':' , , . , , , . . , , , . . , , . , , . . , , , , , . . , , , , . , . . , , , . . . , , . . . , , , . . , , , . . , , , . . , . , , . . . . , , , . . , , , . . , , . , , , . , , , , , , , . . , . . , . . , , , , , , . , , , . , , , , , , , , , , , , , , . , , , . , , ,
<br />
<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 NC Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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