|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />j,f~13to
<br />
<br />Fax-813-780-0021
<br />d}
<br />_ \r\~\.'
<br />e,v'
<br />
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />
<br />~s~..1
<br />ROb er+s-
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel Y V (:> '" "'t::
<br />
<br />
<br />1$ I
<br />i5DO.aD .
<br />
<br />1$ I
<br />1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111111111111111111111111~'-71111111111111111111111111111111111111111111t~ ~flllllll: ",'111'111111'1'11'111111111"11111111111111111111111111111
<br />
<br />BUILDER I ~ - - I COMPANY I Co """---..e":-C,I'e.", \ {o""C.{"~+~ . I
<br />SIGNATURE ,/[. / ~ REGISTERED 1(!.PN I FEE CURRENT r Y/N
<br />
<br />Address I I License # I I
<br />f:':>
<br />~ COMPANY ~~ ~ \ec-\r\ ~ I
<br />REGISTERED I (!jJ N I FEE CURRENT I~ I
<br />
<br />e (' 15()D/ 82-6 I
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />JOB ADDRESS
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />D
<br />
<br />D
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />~L
<br />
<br />B
<br />D
<br />D
<br />
<br />I
<br />B
<br />w
<br />D
<br />~ - '.
<br />
<br />G
<br />
<br />~\ ~ F"l-
<br />
<br />PARCEL ID#I ,\ - ~-,;Ll- 00,0- is:~o -- Cbt~ ()
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />LOT #
<br />
<br />D
<br />D
<br />D
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />ADD/AL T
<br />REPAIR
<br />
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />OTHER I
<br />STEEL D
<br />
<br />OTHER I
<br />
<br />
<br />
<br />t Q l CK'a.-1- ~
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />Ins QIYY\..il.
<br />\r1"~hLA-.
<br />
<br />PROGRESS ENERGY D W.R.E.C,
<br />F Irr. -1x:.>l?S ()'J,. ()EJ@O evw
<br />N c::>c- ~cf)
<br />
<br />Con,()"") . Cern . ~~o. 6D
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />w
<br />
<br />
<br />License #
<br />
<br />~Je.....
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHAN(CAL
<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 />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Pennit for new construction,
<br />Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisions/large projects
<br />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, Stonnwater Plans wI Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster. Site Work Permit for all new projects. All commercial requirements must meet compliance
<br />Attach (2) sets of Engineered Plans.
<br />....PROPERTY SURVEY required for all NEW construction.
<br />
<br />Address
<br />""11""""1
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />jji~~~ti~~~': ' . . , , , . . . . , . . . , , . . , , , , . . . , , , , . . , , , , . , . . , , , . . . , , . . , , . . . , , , . . . . . , , , . . , , , . . . . . . . . . . , , , . . , , . , , , , . , . . . . . , . , , , , , , , . . , , , , , , , , , , , , , , . , , . , , , , , . .
<br />
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|