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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 />
<br />Fax-813-780-0021
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<br />Date'Receivea
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<br />'v1 oe VI ev
<br />~oX' MOOV Ov
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<br />Owner's Name
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<br />Owner's Address I (L>~'2 '1
<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
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<br />I G~L~
<br />I Sl\ V (.\1"
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<br />Fu )( lIVLc. 0 v
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<br />yJv- Z n I' ( I s F \
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<br />PARCELlD#lo 3- l \.r 21 ~ 0 t '2.0 -Oc;'OQO - O~5-D
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
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<br />LOT #
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<br />JOB ADDRESS
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<br />I
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<br />D NEW CONSTR D ADD/AL T D
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
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<br />DESCRIPTION OF WORK [P-e-Vbof 2- ~ St w (~ sO ~CL'i, Glt:i- (l.,M.- ~!Vl{'~
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<br />BUILDING SIZE I ' I SQ FOOTAGE I 2- c.o -S 1 I HEIGHT I 'I
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<br />D BUILDING 1$ .)70 U
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<br />D ELECTRICAL 1$
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<br />D PLUMBING 1$
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<br />D MECHANICAL 1$
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<br />D GAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />SUBDIVISION
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<br />o D, K S
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<br />WORK PROPOSED
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<br />DEMOLISH
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
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<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />ROOFING
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<br />D
<br />I
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<br />SPECIALTY D
<br />FLOOD ZONE AREA
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<br />OTHER
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<br />DYES
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<br />DNO
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<br />'1"1'1"'1"""11""..,..,,"""""1'1111""'1"1II't"'III"'I"""III'II'I"'II"III""""""'"'11.,.'....1'."11.,.,1"..,1111.,.".
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<br />COMPANY
<br />REGISTERED
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<br />BUILDER
<br />SIGNATURE
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<br />Y / N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />
<br />Y/N
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<br />Address
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />ELECTRICIAN
<br />SIGNA lURE
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />Address
<br />
<br />COMPANY
<br />REGISTERED
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<br />~~H::TURE //~~ ~_u
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<br />Address 1 '~S 3 D 1 0 ,<;- Q .5 z.. pu C:> C:> 'x.. ~ l r1( License # Ice CO J-") <7 S-)
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<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 />S~nitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />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 />Attach (2) sets of Engineered Plans.
<br />"..PROPERTY SURVEY required for all NEW construction.
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<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)
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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 A1C
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<br />FEE CURRENT
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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