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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 />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
<br />
<br />Fee Simple Titleholder Name
<br />
<br />Fee Simple Titleholder Address I
<br />~ tf--M-c..
<br />
<br />LOT # I
<br />
<br />JOB ADDRESS
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />@
<br />D
<br />D
<br />
<br />PARCELlD#ll~-l~- 7-./- 0010-00/00 -00"0
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE 0
<br />
<br />SUBDIVISION
<br />
<br />B
<br />
<br />PROPOSED USE ~-
<br />TYPE OF CONSTRUCTION 0
<br />
<br />DESCRIPTION OF WORK LR. 'fP Ilf-c -e ST't-V l"'L- L /A/-e
<br />
<br />BUILDING SIZE I SQ FOOTAGE I HEIGHT I
<br />11'111111'11111111"1"111111"111111111111111111'1111111111111'111111111"111111111111'11'1111111111111111111111111111111111'111111111"111111111
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />
<br />FRAME
<br />
<br />o
<br />o
<br />o
<br />
<br />DEMOLISH
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />1$ I
<br />1$ I
<br />1$ /S60re- I
<br />1$ I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111I1111111111111111111111111111111111111111111111111111111111111I111111111111111111111111111111111111I11111111111111111111111111111111111111111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<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 />D
<br />
<br />~
<br />
<br />PLUMBING
<br />
<br />D
<br />
<br />MECHANICAL
<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 />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />---
<br />
<br />COMPANY
<br />REGISTERED I Y / N I FEE CURRENT
<br />
<br />I ~ II-€-. License # I
<br />
<br />COMPANY 1(?";;PJ(t'A.. f/ 4.P..~/~ St"~v/( ~ r~.
<br />REGISTERED I Y / N 1 FEE CURRE I Y / N I
<br />
<br />I License # rFC(qU3~ c;q
<br />
<br />Y/N
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />~~
<br />
<br />COMMERCIAL
<br />
<br />Address
<br />
<br />MECHANICAL I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I License #
<br />
<br />111111111111111111111111111111111111111I11111111111111111I11111I111111I1111111111111111111111I1111111111111111111111I11111111I111111111I1111111111
<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 onsile, 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 wI 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 />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />SIGN PERMIT
<br />
<br />Di~~~ti~~~': ' , . , , , . . , , , , . , . . , , . , , , , , . , , , , , , , , , , , , . , , , , , , , . , , . . , , , . , . , , , , , , , , , . . , . , , , , , , , . , , , , , . , . . , , , , , , . , , , , , , , , , , , . , , . , , , , , , , , , , , , , . , , , , . , . , , , , , ,
<br />
<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)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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