|
<br />813-780-0020
<br />
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Date Received
<br />
<br />Owner Phone Number 2J
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />I 3C;", leI S f~ t4v~
<br />I ~f~ r-- f-k,j/dJ I
<br />
<br />~ NEW CONSTR [==:J ADD/AL T D
<br />INSTALL L:=J REPAIR
<br />PROPOSED USE SFR [==:J COMM D OTHER
<br />TYPE OF CONSTRUCTION D BLOCK D FRAME D STEEL
<br />
<br />DESCRIPTION OF WORK I ilL ~f d#!wf- SL.., La
<br />
<br />BUILDING SIZE ISQ FOOTAGE I P HEIGHT
<br />
<br />I lOT # I J a-
<br />
<br />PARCEL 10#//;) ~ ~ - d- f - CCJ3:;> -. a:?1 cx;J -. 0/ cf6
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />I
<br />D
<br />)'7
<br />I
<br />
<br />OTHER I
<br />
<br />[J
<br />
<br />I , I , I I I . I 1 I I . I , , , I , 1 I , pi' I I . , I I , I . , . I . I I fl' ~ I , , , I I I I I I , . I . , , , I I . , . , I , I I I . , . . , I I , , . . . I . P r I I I , , I . . I I I , . I I I , , I . I P , I I I . I I . I , I I I I . . . I I I I I I I . I I . I I I . I I I ,
<br />
<br />D
<br />
<br />BUILDING 1$ 3 )'70 06
<br />ELECTRICAL 1$
<br />PLUMBING 1$
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />D
<br />
<br />D
<br />
<br />D MECHANICAL r
<br />
<br />D GAS d~ROOFING
<br />FINISHED FLOOR ELEVATIONS
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />I
<br />
<br />SPECIALTY c=J OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />III 11111111 ' , II .. 11111111 11111 111111111' .. 1111 1 , ' .. I' 11111 " 11111111111111111111111111111 " 1111111111111 ' III i , 11111111111111111' , I , ' .. r ' III , II " "
<br />
<br />Y/N FEE CURReNT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />Y/ N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<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 />Address I
<br />
<br />MECHANICAL I
<br />SIGNATURE .
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />
<br />License # I
<br />
<br />
<br />,41~nr~ F~~~tJ I Y/N I
<br />
<br />License # I c..cc I J J S"J' 0 .f-
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Address
<br />
<br />11I111111111111111111111I11I11III111I1111I1I11I1111I1I11111111111111I11111111111111111111111111111111111111111111111111111111111111111111111111111
<br />RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-Q-W Permit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onslte, Construction Plans, Stormwater Plans w/ Slit Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslonsllarge 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 onsite, Construction Plans, Stormwater Plans w/ 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) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />11111111111111111111111111111111111111111111111111111111111111111111111111111111111I1I11111111111111I111111111111111111111111111111111111111111111
<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 />Reroors Sewers Service Upgrades NC
<br />
<br />Fences (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|