HomeMy WebLinkAbout21-3210�'l y 5 "-re-p-fKy-r-fffffs-
�V
5335 Eighth Street
Zephyrhills, FIL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
t . .. . .. ... .....
,I .01- ... ....... 0"t g V .....
BGR-003210-2021
Issue Date: 11/16/2021
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.
Kz�=IIlII!IlllRIl!lill 11110111!111�11111 il I'll, 1=- = ��
EMEMEME=
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.
111 .114 111, [.*1 U
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
MIMM
1W E/ e- --/X
I caner®s Name
Owner's Address
Fee Simple Titleholder Name
SUBDIVISION
WORK PROPOSED
El
NEW CONSTR
E]
INSTALL
PROPOSED USE
SFR
TYPE OF CONSTRUCTION
BLOCK
r ------------ 1
LOT #
PARCEL ID#
Eb�-' -
REPAIR
Comm
FRAME
0
ale ztll- -4-0oz-
SIGN DEMOLISH
N
BUILDING SIZE SO FOOTAGE = HEIGHT rqrT"r-r"rT1rT-rT"r1
-T"r4-r4-W-r"1- rlrlrlrqrlr"ry
-)�-=BUILDING VALUATION OF TOTAL CONSTRUCTION
=ELECTRICAL AMP SERVICE PROGRESS ENERGY W.R.E.C.
=PLUMBING
=MECHANICAL r$ VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS = FLOOD ZONE AREA =YES NO
BUILDER COMPANY
N FEE CURREN Y/N
SIGNATURE REGISTERED Lc:�&
Address License #
ELECTRICIAN COMPANY E
SIGNATURE' REGISTERED ;;Y;/;NFEECURREN
Address I License # E-
PLUMBER COMPANY E
SIGNATURE REGISTERED �Y l N FEE CURRENY
Address License #
MECHANICAL COMPANY E
SIGNATURE REGISTERED ;;;FEE �CURREI\
Address License #E=:===
OTHER COMPANY E
SIGNATURE REGISTERED ;Y ;/;N FEE CURREN �Y
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 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 wl 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. (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)
a 0 i A I 1 0 1" 0 1
LON I MWO] OWN Ii = Vd QH 442 I IIIIIII ILI MM RJR U-11 H I
1,
provisions of this instrument.
have read and fully understand and agree to the
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 following
conditions:
I/Masterforms/OwnersAffidavit[NovO7