|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Ii' Date Received -/3 - tJ 7
<br />
<br />#' Owner's Name S feu!:}), JI1ar':7€ It;,
<br />/ Owner's Address 15 /3 3 q f II .s-f
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />OWner Phone Number I
<br />
<br />OWner Phone Number I
<br />
<br />/ JOB ADDRESS
<br />
<br />Fee Simple Titleholder Address I
<br />
<br />Is- / 3;7 Cf f;' 5 f
<br />I
<br />
<br />PROPOSED USE
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />Z el);yrh,I/5 R 53 5-9'~
<br />
<br />I PARCELlD#1 \ \ -'J...lc -~;l\ - OU\o- \CY3o 0 . 0/.-)70
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />~ ADD/ALT D SIGN D MOVE D
<br />D REPAIR
<br />D COMM D
<br />D FRAME D
<br />
<br />SLob
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />DEMOLISH
<br />
<br />B
<br />D
<br />
<br />TYPE OF CONSTRUCTION D
<br />
<br />1 ,{rV'61
<br />#"DESCRIPTION OF WORK 0{ LL ~
<br />
<br />BUILDING SIZE I I sa FOOTA~E I L/ Co HEIGHT I
<br />III I , , , , ' , , 11111111111111111' . 11111111 11111111111111 , , II " 111111111111111111111111' I , 11111111 , 11111111111111111 , 11111111111111111 " , " I " II , 11111
<br />
<br />/' 1$ / toe. ()(;
<br />1$
<br />1$
<br />1$
<br />
<br />D GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />11111111111111111111111111111111111111111111'11111111111111111111111111111111111111111111111111111111111111111111111111111111I11111111111111111111
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ELECTRICAL
<br />
<br />AMP SERVICE
<br />
<br />D P~'p-GRESS ENERGY D W.R.E.C,
<br />
<br />I\JO t\1"* i}:"'j1< {)f)\L ~ t' d S\c-...L L') On ~
<br />I~ t~, ~.rn.:u~ .~
<br />
<br />D
<br />D
<br />D
<br />
<br />PLUMBING
<br />
<br />MECHANICAL
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />:~~~~~R~'lft a ,f}Jt..,.#
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />'I f-lOfl'It.. owner
<br />I Y I N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />License #
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />YI N I FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />YI N FEE CURRENT
<br /> License #
<br />Y/N FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />License #
<br />11111111111111111111111111111111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111111111111111
<br />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 Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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. Stormwater 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 />DI~~~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 (PloVSurvey/Footage)
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|