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<br />813-780-0020
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<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
<br />
<br />Owner's Name
<br />
<br />SI'ck 1t6
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<br />Owner Phone Number
<br />
<br />Owner Phone Number I
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<br />Owner Phone Number I
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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
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<br />I 4-7 0 ~ S II uu- & I LOT # I
<br />~t V'n!ltg~ PARCELlD#115-~~T:.:!,IF:oP~!f';T~~~p'-OBiPO
<br />
<br />D NEW CONSTR D ADD/ALT D SIGN D MOVE 0 DEMOLISH
<br />[S] INSTALL D REPAIR ~
<br />PROPOSED USE 0 SFR D COMM 0 OTHER 1c.h0l O'ff -At SL{~
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D '-6THER _ _
<br />
<br />DESCRIPTION OF WORK I c.-h j 0 ~ A k s Y 5+erY' I
<br />
<br />
<br />BUILDING SIZE I SQ FOOTAGE I I HEIGHT I
<br />TfTTTTI I"'" 'II""'" 11111111111111111111111"" '11111111111111111111111111111111' 111'1111111111111111111111111111' II'" '11111111111111111111111
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ 3 600 00 I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11111111111111111111111111I11111111111I1I11I111111111111111I11111111II111111111111111111I111
<br />
<br />JOB ADDRESS
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<br />SUBDIVISION
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<br />WORK PROPOSED
<br />
<br />D
<br />
<br />BUILDING
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />ELECTRICAL
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<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />D
<br />if;J
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<br />PLUMBING
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<br />MECHANICAL
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
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<br />FEE CURRENT
<br />
<br />Y/N
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<br />Address
<br />
<br />License #
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<br />ELECTRICIAN
<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 />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />
<br />Address
<br />
<br />
<br />License #
<br />
<br />ICAC05g575
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License #
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<br />11111I11111111111I11111I111I111111111111I111111I1111I11111I1111111111111111111111I1111111111111111111I111111111111111111111111II11111I1III111111II
<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 wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 wI 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 />
<br />Di~~~ti~~~': ' . , , , . , , , , . . , , , . , , , , . . , , , , . , . . , , , . . . , , . . , , , . , . , , . . . , , , , . , . , , , . . , , , . , , . , , , , . , , , , . . . , , , . , . . , , , , , , , , , , , . . . , . . , , , , , , , , . . . , . . . , . , . . , , . , , . . , ,
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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)
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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 AlC Fences (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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