|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />13~320.e>f' ~6
<br />I
<br />
<br />SUBDIVISION
<br />
<br />I
<br />
<br />D NEW CONSTR ~
<br />D / INSTALL ~
<br />G2f SFR CJ
<br />c==J BLOCK c==J
<br />
<br />I ~~ ~i-- \~ [
<br />
<br />ISQ FOOTAGE
<br />
<br />PARCEL ID,I
<br />
<br />\ l- 'Jlr A - eo' 0 -I OX>O ~.. 0;1\ Cd
<br />(OBT AlNED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />LOT# ~e,;;I.{,a.2.,~3)4
<br />
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />D
<br />
<br />D OTHER
<br />c==J STEEL c=J
<br />
<br />I'k.p\ta~ clU~L'l
<br />
<br />~ HEIGHT I
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER I
<br />
<br />DESCRIPTION OF WORK
<br />
<br />BUILDING SIZE
<br />
<br />, I I I I II , , I , , , , , , , I , , I I . , . I . . I . . t II I . I , , . II' I' I . I . , , , , I . I I I , , , I . . I I I , I , I I . . I I , . I . I I . I I . r r I . III , II . I . , I I I . , . I I I . . I I , . I I I 1'1' , I , ,. I . I III , II , . I , , . I . . I
<br />
<br />0 BUILDING 1$ Q375-.0~ I VALUATION OF TOTAL CONSTRUCTION
<br />D ELECTRICAL 1$ I AMP SERVICE c==J PROGRESS ENERGY D W.R.E.C,
<br />D PLUMBING 1$ I
<br />D MECHANICAL 1$ ~ VALUATION OF MECHANICAL INSTALLATION
<br />D GAS IT2 ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111'11'111"111"1'1'111'111111111'1111111111111""'111111111111111111111111111111111111"11"""""1'111"111"111111111111'11111111111"11'11
<br />
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />
<br />
<br />OTHER ~/~-I". l?O()-1.~ ~ I
<br />
<br />SIGNATURE I YP N I FEE cu~~1......J I YI N I
<br />
<br />Address License # I f:U- / Jl r-SoS- I
<br />
<br />I1111111111111I1I111I1I111I11111I11II1I111111I1111111I111I1111111111111111111111111111I111111I11I1I11II111111111111II1111I11111IIII1111111I11I11II
<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/ Sill Fence Installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdlvlslons/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 onslte, Construction Plans, Stormwater Plans wI Slit Fence Installed,
<br />Sanitary Facilities & 1 dumpster. Site Wo.dU'ermlt 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 />111111111111111I1111111111111111I1111I11111111111111111IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItlllllllllI11I1I1111111111111111111111I1II111111
<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
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N FEE CURRENT
<br /> License #
<br />YIN FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />ELECTRICIAN
<br />SIGNA lURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YIN
<br />
<br />Address
<br />
<br />
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Fences (Plol/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|