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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 />
<br />Av<2
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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 />
<br />Fee Simple Titleholder Namel
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<br />./ JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />137L-/ IS"'
<br />I Qj f(W!)
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<br />I
<br />I
<br />N aA J.- f-tJm ;-:1 V <( I LOT # I I
<br />VlriIZCY;S I ~RCELID#I 30- d5 - dr- dOCJo - 00000 - io~ol
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR CJ ADD/AL T D SIGN D MOVE D
<br />D INSTALL c::::J REPAIR
<br />D SFR D COMM D
<br />D BLOCK D FRAME D
<br />
<br />LthnLj'tCY ~ GL-\ A Ie
<br />
<br />I SQ FOOTAGE I
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />:')14st]
<br />
<br />HEIGHT I
<br />
<br />/' DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />TIIIIIIIIIIIII",,"'II..II.IIIIIII.II"'I"'.IIII,I"111"11111111111111'11""1111111111111111111111..'."11111111111111111111111111111111111111
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ ~, , C{'f) ..QQ I
<br />I
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'111111111111111111111111111111111111111111111111II111111111111111111111111111111111111111111111111111
<br />
<br />~U1LDER COMPA~I
<br />SIGNATURE REGISTERED
<br />
<br />0 BUILDING
<br />0 ELECTRICAL
<br />d PLUMBING
<br />MECHANICAL
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
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<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
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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 /> Address License #
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y I N FEE CURRENT Y/N
<br /> Address License #
<br />i/ PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/N FEE CURRENT Y/N
<br /> Address License # I
<br /> MECHANICAL ~(\S' A Ie Ocvn~
<br /> SIGNATURE Y I N I FEE CURRENT' Y N I
<br /> Address License # I (' A('() ')"8<) 7 c)
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y I N FEE CURRENT Y/N
<br />
<br />
<br />Address License #
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<br />1I111I111111111I1111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111111111
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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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
<br />COMMERCIAL 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 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 Attach (2) sets of Engineered Plans.
<br />"..PROPERTY SURVEY required for all NEW construction.
<br />
<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)
<br />
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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