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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 />Fax-813-780-0021
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<br />Date Received
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<br />Owner's Name E.' C:s- . Q..m
<br />Owner'sAddress l4qo} lq+h&.J.-. Zephl.j(h/ll~. fL3~~ I
<br />Fee Simple Titleholder Namel I
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<br />JOB ADDRESS
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<br />Fee Simple Titleholder Address I
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<br />I4DtQ\
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<br />\ '1% S+. Lph'1(h,\\~ ~L. O~~.l..-- LOT # \
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<br />I PARCELlD#II~-2f.,-d.-.l-OO\O-'01..~oo.. 00 10
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />E3 ADD/AL T rzJ SIGN D MOVE D
<br />REPAIR
<br />c==J COMM D OTHER
<br />D FRAME D STEEL D
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<br />SQ FOOTAGE I I HEIGHT I
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<br />SUBDIVISION
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<br />DESCRIPTION OF WORK
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<br />E3
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<br />D
<br />I
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<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
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<br />DEMOLISH
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<br />WORK PROPOSED
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<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
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<br />OTHER I
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<br />(SOA
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<br />BUILDING SIZE
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<br />D
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<br />BUILDING
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<br />1$
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<br />CfQ ELECTRICAL 1$
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<br />o PLUMBING 1$
<br />o MECHANICAL 1$
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<br />o GAS D
<br />FINISHED FLOOR ELEVATIONS I
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<br />ROOFING
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />AMP SERVICE ~ PROGRESS ENERGY
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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 />BUILDER I
<br />SIGNATURE
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<br />Address I
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<br />Address "PO ~~~ ~"'4{"'1\~ f.... 3~"l-o"6Io'l.... I
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<br />Y/N
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<br />COMPANY
<br />REGISTERED
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<br />Y / N
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<br />FEE CURRENT
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<br />COMPANY
<br />REGISTERED
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<br />License # I
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<br />~e~~;E~~~~~ IrfiN I
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<br />License # I,~q I~bt) I~S ~
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<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 />MECHANICAL
<br />SIGNATURE
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<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
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />Address
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<br />111I11111111111 11I11111111111I111111I111111111111I111111111111I111111I1111111111111111I11111111111111I1111111111111111111111111111111111111111111
<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 subdivisionsllarge 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 onsile, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />S~nitary 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 />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<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 (PloUSurvey/Footage)
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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