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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />~ ~)C(V
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<br />Fax-813-780-0021
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<br />Date Received
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<br />
<br />
<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 />Owner's Name v,bev'-\-'{, G'tvlc:e~ He l'jV\,
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<br />Owner's Address I ~ '2.)"3 1-hAV\. h",yf-o"" 0,'
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<br />Fee Simple Titleholder Namel
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
<br />Iii I-f3 t-h..tv\ t\'-"ff-v~ Or
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<br />L2d Vt\1 OC\ kJ
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<br />WORK PROPOSED
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<br />E3
<br />D
<br />D
<br />1/4
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />tjl( 5(
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<br />SQ FOOTAGE I
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<br />2 (ph'J V J.,',1J F I 33 SCf 2-
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<br />PARCELlD#16 3- 2-1(;-2....\ -OI2.D -00000- 1"3 'f ()
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
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<br />LOT#
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<br />SUBDIVISION
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
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<br />D
<br />D
<br />D
<br />
<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />DESCRIPTION OF WORK
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<br />I HEIGHT
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<br />I
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<br />t;A~- /;t"Lki- It M
<br />I
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<br />OTHER I
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<br />BUILDING SIZE
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<br />I . . I I . . I I , . . . I I . . I , I I ~. I I I . . I I . . . I . . . , I . , . . . . I r . . . 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 I . I . . I . I I I I . . . . . I . . . . . . . . r . . . .
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<br />D BUILDING 1$ }q5~i), U 0
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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 ~ ROOFING
<br />FINISHED FLOOR ELEVATIONS I
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<br />I
<br />I
<br />I
<br />I
<br />D
<br />I
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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 TOTAL CONSTRUCTION
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D OTHER
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<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />
<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED I Y/N FEE CURRENT Y/N
<br /> License #
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<br />Address
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
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<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />I
<br />j~~--_._-_.._,-, I ~~:~~~~ J [cft1~~:c~~~{~;t I
<br />1330ID'..5~ 5'2- fJaf}l)XI/RJ-:/~~ l~jI1 r/
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<br />License #
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<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />License #
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<br />1111I1111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Altach (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 submiltal date. Required onsite, Construction Plans, Stormwater Plans wi 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 submiltal date. Required onsite, Construction Plans, Stormwater Plans wi Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects, All commercial requirements must meet compliance
<br />SIGN PERMIT Altach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />11111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111I1111I1111111111111111
<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 Altorney (for the owner) would be someone with notarized lelter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades AlC Fences (PloUSurvey/Footage)
<br />
<br />Dril~~~~: Q,~.~r ,~~~~~..~~~s.,needs ROW
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