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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 />t 6Z$b Fax-813-780-0021
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<br />Date Received
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<br />SL
<br />;ft/!;OO
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address I
<br />JOB ADDRESS 5531 / ~ T/-f ST,
<br />SUBDIVISION 1 PARCEL ID#I
<br />WORK PROPOSED B NEW CONSTR f5i] ADD/AlT D
<br /> INSTAll REPAIR
<br />PROPOSED USE ~ SFR D COMM D
<br />TYPE OF CONSTRUCTION BLOCK D FRAME
<br /> U G-~frDE ~~~vICe.
<br />BUILDING SIZE SQ FOOTAGE I
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<br />LOT #
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<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D DEMOLISH
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<br />
<br />1'....1'1111...11"1'1111.1."1'1111111'...."1...1111.....'.11...',1'..1111"'1.....'...1111..11.11.1....11..,II.............,."........p,.......
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<br />D BUILDING 1$ I
<br />f$l- ELECTRICAL 1$ J/ 10155; (JD I
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ I
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE /.5l)
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<br />D
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<br />PROGRESS ENERGY
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<br />IR1
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<br />W.R.E.C
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
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<br />DNO
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<br />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 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 />BUILDER I
<br />SIGNATURE
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<br />Address I
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<br />ELECTRICIAN I, 1~
<br />SIGNATURE '-
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<br />COMPANY
<br />REGISTERED
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<br />Y/N FEE CURRENT
<br /> License #
<br /> FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
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<br />Y/N
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<br />Address
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<br />~ I ~~~~:R~~
<br />2.. ztl7 STc~ LINt;- f71/1-,1/t?~ Lf I
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<br />I COMPANY
<br />REGISTERED
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<br />I
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<br />
<br />;::-c POD Z?~61
<br />1
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />Y/N
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
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<br />I11I111111I1111 111I111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111111I111111111111111111
<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) 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 on site, 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 />111111111I111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIi
<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)
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<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 A1C Fences (Plot/Survey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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