|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />raX-tn,j-ltlU-UU':: I
<br />
<br />Date Received
<br />
<br />
<br />Owner's Name Gr () 0 201\
<br />Owner'sAddress 17~45 Cree,vI S\O?f, Dy
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number L
<br />
<br />I
<br />
<br />B
<br />D
<br />D
<br />h ()\'Y'\-t ~e+ - lAP
<br />SQ FOOTAGE I 2 D CZS 0
<br />
<br />~
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />DESCRIPTION OF WORK I rn 6~ i \ e..
<br />
<br />1 S 'J )( L--I 0 I
<br />
<br />.11..'...111..111......11..111.111..111...111...11.......,...".."..."...........,......'I..i"....."I.....,..'1'...11....11111'........111111.
<br />
<br />~ 0 I ooe). (>0
<br />
<br />-
<br />
<br />1$ L 500. n{)
<br />1$ 6CO,~a
<br />1$ 1500. ou
<br />c=J GAS D
<br />
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />JOB ADDRESS
<br />
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />BUILDING SIZE
<br />
<br />c=J
<br />
<br />BUILDING
<br />
<br />D
<br />c=J
<br />c=J
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />ROOFING
<br />
<br />
<br />LOT# 13 l3
<br />
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />D
<br />D
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />DEMOLISH
<br />
<br />OTHER 1h'10Pllt \',o\Y1.L
<br />STEEL 0 OTHER I
<br />
<br />HEIGHT I
<br />
<br />I
<br />1
<br />1
<br />1
<br />D
<br />I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />VALUATION OF MECHANICAL INSTALLATiON
<br />
<br />D
<br />~,.I~e,
<br />~RJI/
<br />~OL-
<br />
<br />W.R.E.C.
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />AMP SERVICE
<br />
<br />SPECIALTY D
<br />
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />III I II , II It , , , .. II , II . I I I II II . I I I II I II . , r I I H , I . I I I I I " I , , . III , 11 . . I 1111 , , I , . , I I I II " , . , I , II , . , .. IIII " I . , . . II " IIIII , t I , , IIII t I It I , . 11111111 , , I , .
<br />
<br />:~~::=:s !~~v~
<br />
<br />
<br />ELECTRICIAN~',""-'-'_,
<br />SIGNATURE ~~
<br />
<br />Address
<br />
<br />
<br />:~~::;J:.E r-~ro
<br />
<br />Address
<br />
<br />
<br />~I~~~~~I~:L!~~
<br />
<br />Address ,
<br />
<br />OTHER I
<br />SIGNATURE
<br />
<br />Address I
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />1 (Ju1ie~f1eJd ^1l-LS
<br />I. - Y I N I FEE CURRENT '
<br />License # I
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />18~hr...)
<br />Y I N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License # I
<br />
<br />II!f~tf1~tc~!i~
<br />
<br />
<br />License # I
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />I ~/{h~~
<br />Y I N I
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans wi Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />COMMERCIAL Attach (3) sets of Building Plans; (1) set of Energy Forms. R-O-W Permit for new construction.
<br />Minimum ten (10) working days after submittal date. Required onsile, Construction Plans, Stormwater Plans wi Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />SIGN PERMiT Attach (2) seis of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW consiruclioi1.
<br />II1II1I111I1111111I1I11I1111IIIII1111I1 II11I1I1II111I111I111II11II11I1111II1111II111I11I11I111II1II1IIII111111 i.; II i: I Hill! ~ 11'11 i I1I1I11111I1111
<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 />
<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 Fences (PloVSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|