HomeMy WebLinkAbout21-3254City of Zephyrhiliz;
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021 1
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R,003254-2021
Issue Date: 11/23/2021
accordance with City Codes and Ordinances. NO OCCUPANCY BEFORE C.O.
NO OCCUPANCY BEFORE C.O.
IA
CONTRACTOR' SIGNATURE PE IT OFFICE
FERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER
813-780-0020
Date Received
Owner's Name
cif Co -
Owner's Address S F-1 clo-
I
Fee Simple Titleholder Name �
Fee Simple Titleholder Address
JOB ADDRESS
SUBDIVISION
WORK PROPOSED
PROPOSED USE
TYPE OF CONSTRUCTION
DESCRIPTION OF WORK
City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
Owner Phone Number
Ad LOT #
PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
W
NEW CONSTR,M'
ADD/ALT
INSTALL
REPAIR
SFR
Comm
BLOCK
FRAME
no
0
SIGN DEMOLISH
BUILDING SIZE SQ FOOTAGEE=:y HEIGHT
=BUILDING' — ) VALUATION OF TOTAL CONSTRUCTION
00"
=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
Address License #E:==:=
ELECTRICIAN COMPANY E;;;;
SIGNATURE, REGISTERED Y/ N FEE CURREN
Address E========= License
PLUMBER COMPANY E
SIGNATURE REGISTERED ;;;�=�FEECURR�ENY ( N���
Address License #E=:===
MECHANICAL COMPANY F_
SIGNATURE REGISTERED L_yl_ N J FEE CURREN Y/N
Address License #
OTHER COMPANY E
SIGNATURE REGISTERED �Y / N�FEECURRENY ( N��
Address License #
If III 111 11111111 111 111111111111111111 1 If 111111 111111 111111 111 111 111 111111 111 If
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 & 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. (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)
Driveways -Not over Counter if on public roadways..needs ROW
NIVAUO VAN
I, 1/11'C'k L have read and fully understand and agree to the
provisiop,i 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 Foil —owing
conditions:
WITNESS PERMIT
UMasterforms/OwnersAffidavit/NovO7