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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application LJ-, rf/13
<br />Building Department ~
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<br />Fax-813-780-0021
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<br />Date Recei,ved
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<br />Owner Phone Number C'
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<br />Owner Phone Number [
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<br />Owner Phone Number I
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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 "
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<br />JOB ADDRESS
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D DEMOLISH
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<br />WORK PROPOSED
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<br />SFR c==J
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<br />SUBDIVISION
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<br />BUILDING SIZE
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<br />HEIGHT I
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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<br />1$ /3, ()lId. 07 I
<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I VALUATION OF MECHANICAL INSTALLATION Fp'x 1-5L,;)-~,' ,.
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<br />D GAS D ROOFING c==J SPECIALTY D OTHER ~ ~ pwl--
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />PROGRESS ENERGY
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<br />W.R.E.C,
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<br />PASC.;() r:>r::-F.:~\;j'j-r
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<br />(813)
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />IJM/'!J 4~ . -D-C .
<br />I Y / N I FEE CURRENT I Y / N I
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y / N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
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<br />License #
<br />1111I11111111111111I1I1I11111111111111111111111111111111111111111111111111111111111111I1111111111I111111111111111111I1I111I11I1111
<br />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, Stonnwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
<br />Attach (3) sets of Building Plans; (1) set of Energy Fonns. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater 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 />Di~~~ii~~~': . , , , , , , . , , , , . . , , , , , , , , , , , , . , , , , , , . . . . , . , , , , , , , , , , , , . . , , , , . , , , , . , , , , , , , . , , , . , , , . , , , , , , , , , . . , , , , . , , . . , , , . , , , , , , . , , , , , . , , . , , . . , . . . , , . , , , , .
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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 />Address
<br />11/111111111111
<br />RESIDENTIAL
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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