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<br />813-780-0020
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date 'Received
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />,;;//5 ,P13SStL
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />/5J.Jh
<br />I
<br />
<br />2ef'l.r,.h,/1t Fl. 33S'/1..
<br />
<br />I PARCELlD#1 /1-.:(' -~/-OOICJ- /,pIM- tPOS'l)
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR E3 ADD/ALT D SIGN D MOVE D
<br />D INSTALL REPAIR
<br />PROPOSED USE D SFR D COMM D OTHER I ~A/fh,11 4al<::rtcy .L(~jd""'1
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL D OTHER I
<br />
<br />DESCRIPTION OF WORK I~~ C~~ ,J.l;~ ~ ,fU-'L ~/Jf~~
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I
<br />TIIIIIIIIIIIIIIIIIIIIIIIIII""""""I'.IIIIIIIIIIIII1111111111111111111'11"""'1"11111"'1""1111111111I11111111111111111111111111111111111
<br />
<br />6ufl Blvd /1/1;/ "'t
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />o
<br />
<br />1$ I
<br />1$ ,{'It .Ii I
<br />
<br />o PLUMBING 1$ I
<br />
<br />o MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111111111I1111111111I11111111111111111111111I11111111111111I1111111111111111111111111111111111111111111111111111111111111111111111111111111I11I111
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />~
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN ~ ') . } ~
<br />SIGNATURE . ~ /n - ,?(/~
<br />Address
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />4~/~ C/...<:.lrl~
<br />I Y / N I FEE CURRENT I Y / N
<br />
<br />License # I E~ -".01';;>" 8'
<br />
<br />7/1,;(37
<br />
<br />PLUMBER
<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 />
<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 />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />111111111111111111111111111111111I111111111111111111111111I11111111111111111111111111111111111111111111111111I11I11111111111111111
<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, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />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 />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
<br />
<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 />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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