|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />rax-l:l1 j-(l:lU-UULI
<br />
<br />Owner's Name
<br />
<br />Owner's Address I ~ xl g 5"
<br />Fee Simple Titleholder Nam~
<br />
<br />5 .-.;}~-o(P
<br />FLt) ~; QA Mt!!()t ~-4<-
<br />
<br />
<br />~
<br />S~4tU
<br />
<br />Owner phone Number
<br />
<br />Owner phone Number I
<br />
<br />OWner Phone Numb~r I
<br />
<br />Date Received
<br />
<br />/71()#i.~ -r
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />1..3313 S"
<br />I
<br />
<br />ma.-rj~,?,
<br />
<br />Se.....a-tee: LOT ##
<br />
<br />I PARCEL ID#I~. ~ ,-. ,:9,. 00/0 .0'3 qoO. 00..30
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR r=::J' ADD/ALT 0 SIGN D MOVE 0
<br />D INSTALL CJ REPAIR
<br />PROPOSED USE 0 SFR 0 COMM 0 OTHER I n4~Jv,~~r..sJID,.,.J
<br />TYPE OF CONSTRUCTION D BLOCK 0 FRAME 0 STEEL D OTHER.I
<br />
<br />DESCRIPTIONOFWORK 1/,.v~ ;-,/,..E -C~;"..r.s,J.J $sr~
<br />
<br />BUILDING SIZE I I SQ FOOTA~E I I HEIGHT I I
<br />
<br />".,..,.".."..,.".,."...,.,....,....................................,....................................,..................'..,.......'...,1,
<br />
<br />D BUILDING 1$ s-Sty:) ~ VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ AMP SERVICE t:=l PROGRESS ENERGY D
<br />
<br />D PLUMBING 1$ ~DC-
<br />
<br />D MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION .rf ~ - 5/C}~
<br />
<br />D GAS 0 ROOFING 0 SPECIALTY 0 OTHER ~
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO .
<br />
<br />SUBDIVISION
<br />
<br />DEMOLIsH
<br />
<br />WORK PROPOSED
<br />
<br />I
<br />I
<br />I
<br />
<br />W.R.E.C.
<br />
<br />.',1",.,1.",.".,.,,1.,..........',..,'...,..........,....................'...,..............,.........."'...,1......,."..,1..'",.'.,'.".".,
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms
<br />Minimum ten (10) working days after submittal date. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms.
<br />Minimum ten (10) working days after submittal dale. Required onslle, Construction Plans, Sanitary Facilities & 1 dumpster
<br />All commercial requirements must meet compliance.
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction. ,
<br />111111111111111111111111111111111.111111111.1111111.111.I.lll.IIIIIIIIIIIIIII.liIIIIIII11iiilllllilli.lllili1IIIIilillllillliilllilliiliiiiiliiliii
<br />Directions:
<br />Fill Qut application completely.
<br />Owner & Contractor sign back of application. notarized
<br />If over $2500, a Notice of Commencement Is required. (AlC 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 AlC Driveways Fences (PloUSurvey/Footage)
<br />
|