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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 />Date Received
<br />
<br />
<br />;vi
<br />
<br />LA ;at)/ 11./
<br />/ yrh sr
<br />
<br />
<br />Owner's Name
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<br />Owner's Address I 5 75"/
<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS
<br />
<br />S<I1M !
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<br />LOT #
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<br /> I PARCEL ID#I
<br /> (OST AINED FROM PROPERTY TAX NOTICE)
<br />E3 NEW CONSTR B ADD/ALT D SIGN D MOVE D DEMOLISH
<br />INSTALL REPAIR
<br />D SFR D COMM D OTHER I
<br />D BLOCK D FRAME D STEEL D OTHER I
<br />I j(~ /L /l /c- 1//1..// 'r
<br /> I SQ FOOTAGE I HEIGHT I
<br />
<br />SUBDIVISION
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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<br />BUILDING SIZE
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<br />. '. I I I . . I I . . p . . 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 I . . I I . . . . J I I . . , . I . . . . .. I . . I I , , . . I . . . . I . . I I I . , . I . I I I I I I I I I t f I I . I . , , ~ ,
<br />
<br />D BUILDING 1$ I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE D PROGRESS ENERGY D WR.E.C.
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ 3/7 S-DtJ I VALUATION OF MECHANICAL INSTALLATION
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />, I I . I , P . . . . P 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 , 1 , I I . I . I I I I I , r , I I r I . , . I , I I . . t I I I I I I . I I I , I , I I . . . , , I I . . , , I I . . . , , . . , , , . . . . . I I
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<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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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 />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />MECHANICAL i
<br />SIGNATURE .
<br />
<br />Address
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />~/l
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />I11111111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 />Sanitary Facilities & 1 dumpster; Site Work Permit for sUbdivisionsllarge 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 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 />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />""PROPERTY SURVEY required for all NEW construction.
<br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111
<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. (A1C upgrades over $5000)
<br />
<br />Agent (for the cqntractor) 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 AlC Fences (Plot/Survey/Footage)
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<br />License #
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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