|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Data Received
<br />
<br />
<br />tro.t..J S
<br />
<br />Owner Phone Number
<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 />5/~4
<br />
<br />JOB ADDRESS
<br />
<br />/ 'I. Sf
<br />
<br />LOT # 1,Jj;/'1
<br />
<br />PARCEL 10#1 f I.~ ~Gr - d../ - 00 10 ,- I? '1 (!) 0 - t!:J1'J. CZ>
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />D
<br />D
<br />D
<br />D
<br />
<br />I
<br />
<br />r:-1/ NEW CONSTR c=J ADD/All D
<br />OZJ INSTALL c::J REPAIR
<br />~ SFR c::J COMM D
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0
<br />
<br />t<-~j A~W+ ~~'~~1
<br />
<br />BUILDING SIZE Isa FOOTAG~I II oCJ I HEIGHT
<br />
<br />I . I . I , , I , , . I I I , . . I I . I , , I . I . I . I . I . I . ~ 111 . II , I . . . I I I I , II I I I I I , , , I . I . , , . . I I I I I I I I I . I I , , . . , , I . II , , , . . I I I , , " , , , .. , , I I I I , I , . I' I I . , , . . I , I I I II , ,. , I , I I I I I
<br />
<br />1$ 3'~ee,. 5')
<br />1$
<br />1$
<br />
<br />
<br />~/ ROOFING
<br />FINISHED FLOOR ELEVATIONS I
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING
<br />
<br />I
<br />I
<br />I
<br />~
<br />D
<br />I
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D
<br />
<br />GAS
<br />
<br />SPECIALTY 0
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DYES
<br />
<br />DNO
<br />
<br />I ' I I I .. 11111I111 ' 1 , , ' 11111 1II111 " 11I1I111 " " I " " " " III " " I " , II " " II " I " " 1 " , .. 1 1 " II " 1I " I " III " " 11111 . " " III ' III " I " III " " I ' II " "
<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 />Y/ N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<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 />~::N"'RruRE I ~1~~ .~~('1jN
<br />
<br />
<br />Address License # I ~ I J~ .J .f <J.r
<br />I11111111I11111111111111111111111111111111111111111111111111111111111111111111111111111I1111111111111I11111111111111111111111I1I111111111111111111
<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 onslte, Construction Plans, Stormwater Plans w/ Silt 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 tor 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 all new projects. All commercial requirements must meet compliance
<br />StGN PERMIT Attach (2) sets of Engineered Plans.
<br />....PROPERTy SURVEY required tor all NEW construction.
<br />1111111111111111111111111111 J I J 11111111111111111111111111111 J 1111 J 1111111111111111111111111111111111111 J 11111111111111111 J 111111111111111111111111
<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. (A1C 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 (Plol/Survey/Footage)
<br />
<br />
<br />
<br />Driveways-Not over Counter jf on public roadways..needs ROW
<br />
|