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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit APPlication. './ f).. '1 ("
<br />Building Department -:rr. [) l Vf/
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<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
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<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />JOB ADDRESS I 59;};) 1~.11J Str~-\ I LOT # I
<br />SUBDIVISION I I PARCEL 10#1\ \ - Jw -:J 1- Do It) - JCl ?oo - (Y) K)
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED fiiJ NEW CONSTR B ADD/AL T D SIGN D MOVE D DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
<br />DESCRIPTION OF WORK I Cflcu10~ ()/ ^' ~ Ale LWl'tt
<br /> ,
<br />BUILDING SIZE I sa FOOTAGE I HEIGHT I
<br />
<br />I I I I I . I I II I I . ~ I I . I I I I I , I I I I 1 1 . . I I I I I I I , I I I I II I I I III I , I I I I I II I I I . I I I I , I I . . . I II I I , , , , I 1111 I III I I , , II II I III , , , II I I I I , t I I I I I I IIII , I I I I I I I I I 11 , III I t I , I
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />rtp MECHANICAL
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<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ L}, g?)(),QQ I
<br />
<br />I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111I1111I1111II111I1111111111111111I11111111I1111I1111I111II1111I1111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
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<br />WR.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER COMPANY
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br />Address License #
<br />ELECTRICIAN I COMPANY
<br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N
<br />Address I License #
<br />PLUMBER I COMPANY
<br />SIGNATURE REGISTERED Y / N FEE CURRENT Y/N
<br />Address I License # I
<br />MECHANICAL ~ I ~ /t'l( tS I ~'~RRE(pn~)~
<br />SIGNATURE Y / N I
<br />Address License # I Gfirc685'75
<br />OTHER COMPANY
<br />SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br />
<br />
<br />Address License #
<br />11I111111111111111I11111111111I1111111111111111111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111II1111
<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 subdivisions/large 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 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.
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<br />DI~~~t;~~~': 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 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 , I . , I , I . , I I I I I I I . , . . I I I I . I , I , . , , , , , , , I , , , , I . , , . ,
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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. (Ale 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 AlC Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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