|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />, -1. ,iJ.
<br />Owner's Address 3 Y 0.5 C;
<br />Fee Simple Titleholder Nam~
<br />
<br />sf- cA(/~
<br />CILc:;-y CAS!-
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I 3f&3</ CL sy
<br />I
<br />
<br />;5/f) r
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />PARCEL ID# I b 2
<br />
<br />I
<br />
<br />c=J ADO/AL T D
<br />r=::J REPAIR
<br />D COMM D
<br />D FRAME D
<br />oESCRroN OF WORK I {CJ ';urlc S'lor.", c SAc.(} P 4!J
<br />BUILDING ~~ 1;2 / 1.;2. 7 I SQ FOOTAGE I I HEIGHT I I
<br />
<br />",..,',..."......"..".........,......,.,...",....,......,..."......,....."..........,.,......:,..,..........."...,..,..,..,...............
<br />
<br />D BUILDING 1$ ,,;2 3 5-0,. I
<br />
<br />D ELECTRICAL 1$ I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />o
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />') bJ... J (.9 () 0 (!) / Lf 0 1J
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE 0
<br />
<br />() (JOQ
<br />
<br />DEMOLIsH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />I
<br />I
<br />I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />o
<br />
<br />W.RE.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />',..,.,.....,',....,.....,.........,.,......"....,...............,.,.....,.,.....,......,.....,..........,..,..........,',..............,."'.'.1
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />ELECTRICIAN I
<br />SIGNATURE .
<br />
<br />Address I
<br />
<br />PLUMBER I
<br />SIGNATURE
<br />
<br />I
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />LIcense #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />MECHANICAL I COMPANY
<br />SIGNATURE . REGISTERED Y / N FEE CURRENT
<br />
<br />Address I License #
<br />
<br />
<br />
<br />~'~~~;.J", ,1. 9.r~" "'""'"".""",,.. ,~~",.,,"'''''''' I~'~~~;;:':~"""""'''''''''''''''''' I
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />LIcense #
<br />
<br />Y/N
<br />
<br />
<br />RESIDENTIAL
<br />
<br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
<br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Sanitary Facilities & 1 dumpster
<br />Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans. Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />Attach (2) sets of Engineered Plans.
<br />'---PROPERTY SURVEY required for all NEW construction.
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />1111111.llllllll.I.IIII,lllllllll,I,llll.I,.,I.I.I.I,1.11,11.1.1111,lll.llIIIIIIIIIIII.II.IIIIII.lllllllllll111111111111.111111111.lllllllllllllli
<br />Directions:
<br />Fill out application completely.
<br />Owner & Contractor sign back of application, notarized
<br />If over $2500, a Notice of Commencement Is required. CAlC upgrades over $5000)
<br />
<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
<br />
<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Driveways Fences (Plot/Survey/Footage)
<br />
|