HomeMy WebLinkAbout22-53215335 Eighth Street
Phone: (813) City of Zephyrhille
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-005 21- 02
Issue Date: 01/13/2023
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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.
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GC}PlTF�fiGTC7R SIGNATURE
813-780-0020 City Of Zephyrhilis Permit Application
Building Department
1/1
Date Received - Ph®ne Contact for Permittin
Owner's Name G f s Owner Phone Number
Owner's Address t10 07 1a f ��Owner Phone Number
Fee Simple Titleholder Name Owner Phone Number
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SUBDIVISION
PARCEL lD#-
(OBTAINED FROM PROPERTY Y TAX NOTICE)
WORK PROPOSED
NEW CONSTR
ADD/ALT
SIGN DEMOLISH
INSTALL
REPAIR
PROPOSED USE E4
SFR
COMM
OTHER
PE OF CONSTRUCTION
BLOCK �
FRAME
�t
STEEL �
DESCRIPTION OF WORK I o oronj-t 2- o
BUILDING $ q ' VALUATION OF TOTAL CONSTRUCTION
ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C,
PLUMBING $rc
MECHANICAL VALUATION OF MECHANICAL INSTALLATION�"e`
�Y7
=GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
BUILDER i COMPANY"
SIGNATURE i ��" � �"� � a � REGISTERED / N FEE CURREN Y / N
Address License #
ELECTRICIAN COMPANY
SIGNATURE � REGISTERED Y / ly FEE C:URREN Y I N
Address License #,_.w,
PLUMBER � � COMPANY°
SIGNATURE REGISTERED ;;;;��FEE CURREN
Address License #
MECHANICAL COMPANY
SIGNATURE REGISTERED FEE CURRER Y / N
Address License #
OTHER COMPANY
SIGNATURE REGISTERED ;;;��FEE CURRER
Address License #
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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 Flans, Stormwater Plans wl 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 Flans, Stormwater Flans w/ Silt Fence installed,
Sanitary Facilities & 1 dumpster, Site Work Permit for all new projects. All commercial requirements must meet compliance
SIGN PERMIT Attach () sets of Engineered Flans.
***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,.nedds ROW
NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to "deed" restrictions"
which may be more restrictive than County regulations, The undersigned assumes responsibility for comp Hance with any
applicable deed restrictions,
UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hire . d a contractor or
contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the
contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation
under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the
•
FLORIDA JURAT (F.S. I
OWNERORAGENT
Whio Ws/arepersonWl�yk"n to me r a duced
as identification.
CONTRACTOR te
WW-�s-ia4�personally known to me or has/have produced
as identification.
. . . . . . . . . . .
UMUMMUERUMN]
LC a have rid fully understand and agree to the
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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 following
conditions:
WITNESS PERMIT
I/Masterfonns/OwnesAffidavit/NovO7