HomeMy WebLinkAbout21-3116City of Zephyrhills
5335 • Street
Zephyrhills, FIL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
C ISC-003116-2021
Issue Date: 08/03/2022
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 • federal agencies.
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accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
• OCCUPANCY BEFORE •
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CONTRACTOR SIGNATURE
PE 1AIT OFFICEU
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Permit No.
Property Identification No.
THE UNDERSIGNED hereby give informs you that the improvement will be made to certain real property, and in accordance with
Section 713.13 of the Florida Statutes, the following information is provided in this NOTICE OF COMMENCEMENT.
I.Description of property (legal description.)
a) Street Address:
2.General description of improvements:
3.Owner Information
a) Name and address:
b) Name and address of fee simple titleholder (if other than owner)
c) Interest in property
4 Contractor Information
a) Name and address:
b) Telephone No.: Fax No. (Opt.)
5 Surety Information
a) Name and address:
b) Amount of Bond:
c) Telephone No,: Fax No. (Opt,)
61endeT
a) Name and address:
-Phone No.
7. Identity ofperson within the State ofFlorida designated by owner upon whom notices or other documents may be served:
a) Name and address;
b) Telephone No,: Fax No. (Opt.)
8.In addition to himself, owner designates the following person to receive a copy of the Lienor's Notice as provided in Section
713,13(1)(b), Florida Statutes:
a) Name and address:
b) Telephone No.: L Fax No. (Opt.)
9.Expiration date of Notice of Commencement (the expiration date is one year from the date ofrecordinga different date is
specified):
STATE OF FLORIDA
COUNTY OF PASCO
Signature of Owner or Owner's Audwized Officer/Director/Partner/Manager
Print Name
The foregoing instrument was acknowledged before me this _ day of 20___, by
I by
in fact) for
as (type of authority, e.g. officer, trustee, attorney
(name of party on behalf of whom histrunient was executed).
Personally Known _ OR Produced Identification I Notary Signature
Type of Identification Produced
Name (print)
Verification pursuant to Section 92.525, Florida Statutes. Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated in it are true to the best of my knowledge and belief.
Sip.. fNantral Person Signing Above
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813-780-0020
City of Zephyrhills Permit Application
Fax-813-780-0021
Building Department
5 SS
Date Received
Phone Contact for Permitti
Owner's Name OAA
pt I i Owner Phone Number
Owner's Address
2
Owner Phone Number
Fee Simple Titleholder Name
Owner Phone Number
Fee Simple Titleholder Address
JOB ADDRESS
At
LOT # Uh
SUBDIVISION
PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORK PROPOSED
NEW CONSTR ADD/ALT SIGN
DEMOLISH
INSTALL REPAIR
PROPOSED USE
SFR COMM OTHER
TYPE OF CONSTRUCTION
BLOCK FRAME STEEL
01-5* •Ml
BUILDING SIZE SO FOOTAGE HEIGHT
=BUILDING 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 q;Y / gNFEE �CURREN �Y I �N��
Address License #
7
ELECTRICIAN c F COMPANY
Zell
SIGNATURE REGISTERED Y/ N FEE CURREN N
Address License #E=====
REGISTERED E ;;;; FEE =CURREN
PLUMBER COMPANY
SIGNATURE
Address License #E====
MECHANICAL COMPANY E
SIGNATURE REGISTERED ;;;;;�FEE CURREN
Address License #E=====
OTHER COMPANY E�
SIGNATURE REGISTERED Y/ N FEE CURREN
Address License #E=====
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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/ Slit Fence installed,
Sanitary Facilities & I dumpster; Site Work Permit for subdivisions/large 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,
Directions:
Fill out application completely.
Owner & Contractor sign back of application, notarized
If over $2500, a Notice of Commencement is required. (AIC upgrades over $7500)
*VER THE COUNTER PERMITTING (copy of contract required)
Reroofs if shingles Sew ers S "'co Upgrades AIC, Fences (Plot/Survey/Footage)
Driveways -Not over Counter if on public roadways. -needs ROW