|
<br />.
<br />Date Received
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />t-ax-tl1 ;j-l!lU-UULl
<br />
<br />813-780-0020
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />:)3S-') J.... ..../S-y/ I
<br />f::L Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I J~ 7rlr \C) 0(.7'/11 A ()rr. I LOT # I
<br />I I PARCELlD#11J ~ro f)-I CO/O '}-I 3m GIlD I
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />D NEW CONSTR D ADD/AL T D SIGN D MOVE D DEMOLISH
<br />D INSTALL D REPAIR
<br />PROPOSED USE D SFR D COMM D
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D
<br />
<br />DESCRIPTION OF WORK I i::!- r: - I2a::JF7=<J 6
<br />
<br />ISQ FOOTAGE I/g~F--
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />HEIGHT I
<br />
<br />BUILDING SIZE
<br />
<br />
<br />1$ 4.4 6() . 1
<br />
<br />,
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />I..' FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1 ~~:~~~~II ,., I , ' , , " I ' 1111111 " , ' IIII111 , 111111' , , , , .. , I '" , ' III , , II . , , 'I ~~~~~~~ " I ' I , II , ' ,.. , , , 1111' ... ~ , , II , III , , ' , , 'II , III , III , II , I , ' , ' , ' , 'I
<br />
<br />
<br />SIGNATURE REGISTERED Y I N FEE CURRENT Y I N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />,Joe, \/'
<br />
<br />W.R.E.C,
<br />
<br />D
<br />D
<br />D
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />OA~!f L ~w0J7J.fc"c"1='~
<br />?&'Vy S'C/2AY)OA-C crj J/u050~ FL
<br />.
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N
<br />
<br />FEE CURRENT
<br />
<br />I Y/N I
<br />I c'Cc/jt-06t-!
<br />
<br />Address
<br />
<br />J'1.667 1
<br />
<br />License #
<br />
<br />111I11111111111 1111111111111111111111111111111111111111' 11111111111111111111111111 , 11111111111111111111111111111111111111111111111111111111111III
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Fonns; R-O-W Penn It for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stonnwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Pennit for subdivisionsllarge projects
<br />COMMERCtAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Pennlt for new construction.
<br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stonnwater Plans wi Silt Fence Installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Pennit for all new projects. All commercial requirements must meet compliance
<br />SIGN PERMIT Attach (2) sets of Engineered Plans.
<br />****PROPERTY SURVEY required for all NEW construction.
<br />111111111111111" 1111111111111 " III " I111111111I111111111111111 " 1111111I11111111111111111111111111111111I111 " 11111111111111111111111111111111111
<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. (AlC upgrades over $5000)
<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 Ale Fences (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter If on public roadwaysooneeds ROW
<br />
|