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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
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<br />
<br />
<br />
<br /><6t~-qql (;JSb
<br />34-0-32.01
<br />
<br />. O-~ \..e e ('ti-K.wrs.-
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<br />Ow..'.sAdd.... 13~~~u)~ ~~
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<br />Fee Simple Titleholder Namel I ~ l-.Q.e '\ u .. .
<br />
<br />Owner's Name
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<br />Fee Simple Titleholder Address I
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<br />13<64-~lNQ.u.) S~
<br />/-T\.\ ~ en '<s I
<br />\
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<br />E3 NEWCONSTR C:=J ADD/ALT 0
<br />INSTALL D REPAIR
<br />PROPOSED USE 0 SFR D COMM 0
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
<br />
<br />DESCRIPTION OF WORK fili-m u \ ~ S~ .3 <; ~&..ooL ~D f~. Ii- [ u m \' n U m
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<br />BUILDING SIZE I \ D -y. ~ I SQ FOOTAGE I () 0 I HEIGHT I '7 I . I
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<br />~.~.........."................................,....,.........,............,....,.........,.....:.................,............,...,....,.....
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<br />BUILDING 1$ VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ AMP SERVICE D PROGRESS ENERGY c:t W.R.E.C.
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<br />o PLUMBING I: (-r17.rf/lq_!'.gg......'iy~ )
<br />o MECHANICAL VALUATION OF MECHANICAL INSTALLATION ~
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<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES
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<br />JOB ADDRESS
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<br />LOT #
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<br />SUBDIVISION
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<br />PARCEL ID#I Od-.-.;:) b "d.1 -co&'"6 -001 OD - 0030
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE ca-- DEMOlisH-?
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<br />WORK PROPOSED
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<br />OTHER
<br />STEEL
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<br />I
<br />D
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<br />OTHER I
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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 , t . , I , I I I I , r I . . . , r . I I I I , . . I , , I . . . I , , I . . . I , P I I r . . , I , I I . . P I I I . I , , I I I . ~ . . , I t r I , , I I I . I , , , I I , I , I I I I r r I 1 I I I
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED Y/N FEE CURRENT Y/N
<br /> License #
<br />COMPANY
<br />REGISTERED I Y/N FEE CURRENT Y/N
<br /> License #
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />111111111111111111'11111111111"'1111111111111"1111111I11111111111111I11111111111I11II1111I111I11II111111I11'11111111111"11111111111111'11111111
<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 />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 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 />111111111111111111111"1111111111111111111111111111111111I111I11111I111I111111111111111111111I11111111111I11111111III111111111111111111I1111111111
<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)
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
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