HomeMy WebLinkAbout21-3086City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
BGR-003086-2021
Issue Date: 10/25/2021
REINSPECTION FEES: (c) With respect to Reinspection fees will comply with Florida Statute 553.80(2)(c) the
local government shall impose a fee of four times the amount of the fee imposed for the initial inspection or
first reinspection, whichever is greater, for each subsequent reinspection.
Notice: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that
may be found in the public records of this county, and there may be additional permit required from other governmental
entities such as water management, state agencies or federal agencies.
Mill
23MOEMZEEEM
Complete Plans, Specifications add fee Must Accompany Application. All work shall be performed in
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
CONTRACTOR SIGNATURE
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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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Date Received I I Phone Contact for Permitting 1(
A � t. � 1. �=l 1 Owner Phone Number
Owner's Address C) c Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS LOT #
5a=M=Ka==7;
SUBDIVISION PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
NEW CONITR
ADDIAIT
11
INSTALL
REPAIR
PROPOSED USE
SFR
Comm
TYPE OF CONSTRUCTION
BLOCK
FRAME
SIGN DEMOLISH
OTHER
STEEL
DESCRIPTION OF WORK 'eLks"y/ ,
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BUILDING SIZE SQFOOTAGE= HEIGHT
InBUILDING 11P VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C.
=PLUMBING
=MECHANICAL VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER COMPANY
SIGNATURE REGISTERED Y/N FEE CURREN Y/N
Address License #E=====
ELECTRICIAN COMPANY E
SIGNATURE REGISTERED ;;;��FEE �CURREN Y
Address License #E=::===
PLUMBER COMPANY E
SIGNATURE REGISTERED ;;;N;�FEE C�URREN
Address E========= License #E=====
MECHANICAL COMPANY E
SIGNATURE REGISTERED FEE CU�RREN
Address License #E:=====
OTHER COMPANY FEE CU�RREII
SIGNATURE REGISTERED
Address License #E=:===
RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge projects
COMMERCIAL Attach (2) complete sets of Building Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction.
Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach (2) sets of Engineered Plans.
****PROPERTY SURVEY required for all NEW construction.
1 as
- - - - - - - - - -
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (A/C upgrades over $7500)
** Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
OVER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage)
11 =i I III; I Eli III I I 1 111, 1 11111•1 1 111111 1
DISCLOSURE STATEMENT FOR OWNER
CITY OF ZEPHYRHILLS — BUILDING DEPARTME]
have read and fully understand and agree to the
provisions of this instrument.
The undersigned states and affirms that he or she is desirous of constructing, renovating, adding to or
reroofing his or her own domicile, that he or she actually occupies, or will occupy by said
domicile, and same is not for rent, lease or sale. That he or she shall comply with the fo—Ilowing
conditions:
OWNER'S SIGNATURE DATE
ADDRESS LhVV,2 2&
PHONE z,7,5-6-2,
FMasterforms/OwnersAffidavit/Nov07