Applications, Forms & Schedules

Applications, Forms & Schedules

Applications, Forms & Schedules


Authorized Agent Affidavit Complete this form if you are the Contractor and wish to designate a person to represent you during the permit process. The authorized agent will have the authority to sign contracts, permits, permit applications, monitoring results and other documents in the property owners’ and otherwise bind the property owner.
Building Permit Application A building permit certifies that proposed work on a building or structure is in conformity with the City Code. See Chapter 6, Buildings and Building Regulations.
Betterment Plan Checklist Use this checklist in conjunction with the

 Tree Removal Permit Application.

Driveway Worksheet New Driveways and/or driveway extensions worksheet for Building permit Applications
Drawing Board Print this on 11 x 17 paper and use to draw a site plan to a 1:20 Engineer’s scale.  Each box represents 20 feet.
Fees Use this to determine the fee for each application.  Building permit fees are paid when picking up an approved permit, not when submitting an application.
Flood Zone Construction Application This application is used to certify, together with plans and specifications, that the construction within a flood zone to be accomplished under the permit See City Code Section 8.05.00, Provisions for Flood Hazard Reduction.
Notice of Commencement (Pasco County) Gives notice to the Pasco County Clerk that improvements will be made to certain real property, and in accordance with Section 713.13, Florida Statutes.
Owner-Builder Disclosure Statement Before a building permit can be issued to an owner-builder, this disclosure statement must be completed, notarized, and returned to the Building Services Division.
Permit Revision/ Resubmittal Request This application must accompany a revised permit application submittal.
Product Approval Submittal Sheet Use this application to provide proposed product and construction methods information for City evaluation relative to applicable building codes.
Residential Swimming Pool and Spa/Hot Tub Safety Requirements Complete this form is you are building new swimming pool, spa, or hot tub to affirm compliance with the requirements of Section 424.2, Chapter 4, Florida Building Code-Building.

Roof Inspection Affidavits
This form is used to certify that a roof installation was done according to the Hurricane Mitigation Retrofit Manual (based on Section 553.844, Florida Statutes) by a professional certified in accordance with Chapter 468, Part XII, Florida Statues.
Sign Permit – Non Downtown or DROD Use this application if the project includes new, existing, or modified signs for non downtown zoning district. See City Code Chapter 13, Signs and Advertising.
Sign Permit (Downtown) Use this application if the project includes new, existing, or modified signs for the downtown zoning district. See City Code Chapter 13, Signs and Advertising.
Tree Removal Permit Application Use this application if you are proposing to remove or relocate a tree. See City Code Section 8.02.00, Tree Protection. Note: Removal of certain tree species does not require a City permit.  This is a new application as of February 18, 2019
Truss Package Structural Verification This form is used by a building design professional to verify that the loads being imposed by the trusses and their anchors are not adversely affecting the underlying structure. The verification becomes part of the approved construction documents.
Utility Impact Fee Form This form is for impact fees for all New Port Richey Utilities, whether inside or outside the city. Firm must presented to the Public Works Department, reviewed by the Planning and Development Department, before payment is made at the Finance Department.
Planning & Zoning
Adult Entertainment License Application Use this application to request an Adult Use.
See City Code Chapter 13, Article X, Adult Use Regulations.
Administrative Appeal Application Use this application petition for an appeal of an administrative decision made by the City.
Concept Plan This is applicable for cases when general guidance and feedback is needed before proceeding with preliminary site plans.
Use this application to request a conditional use or special exception use specifically permitted in the applicable zoning district. See City Code Section 7.00.00, Zoning District Regulations.
Certified Parcel Application  Use this application to request administrative review and determination to allow subdivision of one parcel into two lots. See City Code Section 9.01.01, Subdivision Types. Also see Certified Parcel Checklist CERTIFIED PARCEL CHECKLIST
Certified Parcel Checklist

Use this checklist to help in preparing a complete Certified Parcel Application.

Fees Use this to determine the fee for each application.  Fees are paid for planning applications when they submitted.
Land Use Plan Amendment and Rezoning Application


Use this application to request consideration of an amendment to the Future Land Use Map and/or Zoning Map. See City Code Section 5.01.00, Rezonings.
Mobile Vending Application

Use this application to request consideration of mobile vending use on commercially-zoned property. See City Code Section 7.00.00, Zoning District Regulations, including Section 7.11.00, Downtown Zoning District.

NPDES Detail Sheet Use this National Pollutant Discharge Elimination System Details (NPDES) detail sheet to demonstrate that your construction project will employ appropriate pollution prevention techniques to minimize erosion and sedimentation and properly manage stormwater. See City Code sections 11-66 and 24-412, Stormwater Discharges from Industrial Activities and Construction Sites.
NPDES Signature Sheet

This sheet is contains notes and signatures that accompany the NPDES Detail Sheet.

Performance Option Variance Application Use this application to request the ability to make certain improvements to real property that otherwise would not be allowed by the Land Development Code. See City Code Section 19.00.01, Performance Options. Note:  This process is only used for changes to single-family structures within the R-1, R-2, or R-3 zoning districts. It is not applicable to accessory uses such as pools/enclosures or fences.
Sidewalk Café Permit Application Revocable License Agreement Use both of these forms to request review of a proposed sidewalk café on city right-of-way. See subsections 7.11.14 through 7.11.21 in City Code Section 7.11.00, Downtown Zoning District. Note: Florida Statutes, Sections 561 through 569 concerning alcohol beverages and other City Code requirements are applicable.
Extension of Premises Alcoholic Events
Unity of Title Declaration  Use this form to declare separate lots, plots, parcels, acreage, or portions thereof as unified into one indivisible building site under one title. City Code Section 9.16.00, Unity of Title.
Vacation of Easement/Public Right-of-Way Application

Use this application to request a vacation of easement or public right-of-way.

Variance Application
  • Use this application to seek relief from development standards of the Land Development Code and Building Regulations.  See LDC Section 5.03.00, Variances.

Variance requests are reviewed by the Land Development Review Board (LDRB).  Note:  The schedule may not apply to cases that are incomplete by the application deadline

Zoning Clearance Use this form prior to applying for a business tax receipt, to ensure that your proposal meets zoning requirements.
Zoning Verification Use this form to identify the legal zoning classification and zoning history
Home Improvement Reimbursement Grants Use this application to apply for funds to make certain repairs and improvements to your property (eligibility requirements apply).