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<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
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<br />Date Received
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<br />Chvrct.... of ~~
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<br />Owner Phone Number ~ / 3) 7 .f.2 ~ <PcP J,S
<br />Owner Phone Number I
<br />Owner Phone Number I
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<br />Owner's Name
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<br />Owner's Address
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<br />Fee Simple Titleholder Name It/I I 'Wt( -e (f. v (":...i,.
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<br />Fee Simple Titleholder Address I .5;1-MC t1J 1\-4' 01/.6
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<br />JOB ADDRESS
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<br />WORK PROPOSED
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />LOT #
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<br />PARCELlD#1 OJ-dk,-.)/- C>6/0 :-OC;S7:>() - .:)O~U
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE!3-.
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<br />SUBDIVISION
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
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<br />DEMOLISH
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<br />OTHER
<br />STEEL
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<br />OTHER I
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<br />DESCRIPTION OF WORK
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<br />Urwo
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<br />a.nf#//c-~:d;,~ 0/ ~----
<br />HEIGHT I
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<br />BUILDING SIZE
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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 . 1.1 . . . . 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 />~ BUILDING 1$ .=. I
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<br />D ELECTRICAL 1$ I
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<br />D PLUMBING 1$ I
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<br />D MECHANICAL 1$ I
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<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />VALUATION OF TOTAL CONSTRUCTION
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<br />AMP SERVICE
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<br />D
<br />
<br />PROGRESS ENERGY
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<br />D
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<br />W.R.E.C.
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />
<br />
<br />Address
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<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
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<br />ELECTRICIAN
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />YIN
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<br />Address
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<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
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<br />Y IN I.
<br />
<br />Address
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
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<br />,.""1,1,,,11, ""1",11"1.1"".",,,,111,11111,,1,11,111,,1111,,,111111111111111111111111111111111111111111111111111111111I111111111111111111
<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 wI 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 />111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111 1111111I
<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 AlC Fences (Plot/SurveY/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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