HomeMy WebLinkAbout23-6391 (2)City of Zephyrhills
5335 Eighth Street
Zephyrhills, FL 33542
Phone: (813) 780-0020
Fax: (813) 780-0021
l9-N0063&91-M2023
Issue Date: 10/03/2023
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.
I R I I i I I I I I I I I I I' I! I I I! I! I I I I I I mill 11
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 4PE ITOFFII E
PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTIO
CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED
PROTECT CARD FROM WEATHER i
813-780-0020 City Of Zephyrhills Permit Application
Building Department
Date Received Phone Contact for Permitting
T�
Owner's Name t t� - 1 r- 4— Owner Phone Number
Owner's Address 1 r Owner Phone Number
Fee Simple Titleholder Name _ Owner Phone Number
Fax-813-780-0021
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Fee Simple Titleholder Address
JOB ADDRESS r� LOT #
SUBDIVISION E==== PARCEL ID#
(OBTAINED FROM PROPERTY TAX NOTICE)
WORT{ PROPOSED � NEW CONSTR ADC/ALT SIGN DEMOLISH
INSTALL REPAIR
PROPOSED USE SFR COMM OTHER
RE OF CONSTRUCTION BLOCK FRAME STEEL
DESCRIPTION OF WORKA '
BUILDING SIZE S OOTAGE HEIGHT7'
BUILDING $ i
fz VALUATION OF TOTAL CONSTRUCTION
0 ELECTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C.
PLUMBING $,
MECHANICAL $ 1 VALUATION OF MECHANICAL INSTALLATION
=GAS ROOFING SPECIALTY OTHER
FINISHED FLOOR ELEVATIONS^ FLOOD ZONE AREA =YES NO
BUILDER COMPANY �-1
SIGNATURE "� — REGISTERED N FEE CURREP Y I N
Address License #
ELECTRICIAN COMPANY �FEE
SIGNATURE REGISTERED Y / N URREP Y / N
Address License #
PLUMBER COMPANY r -
SIGNATURE z REGISTERED / N FEE CURREP Y / N
I
Address License # E
MECHANICA COMPANY stone,
SIGNATURE REGISTERED Y / N FEE CURREP
Address License #
OTHER COMPANY
SIGNATURE REGISTERED Y / N �FEERREP Y / N
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 Plans, Storrnwater 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 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 $200, a Notice of Commencement is required. (AIC upgrades over $7500)
Agent contractor) or Power of Attorney (for the owner)• be someone♦..: R. owner authorizing
813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
Building Department
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WWNER OR AGEAT
Subscribed and sworn to (or affirmed) before me this
--by
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Subscribed and sworn to (or affirmed) before me this
by
Whoos-ha-re -personally known to me or has/have produced
as identification.
Commission No.
Name of Notary typed, printed or stamped Name of Notary typed, printed or stamped
INSTR#2023176728ORBK10896PG2067 Page 1 of 1
10,105/2023 01:53 PM Rcpt: 2630942 Rec: 10.00 DS: 0.00 M 0.00
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