|
<br />8.13-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />
<br />Owner's Name
<br />
<br />rist, ne- rWntUl\
<br />5303 l2>elfya)n Dr
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Fee Simple Titleholder Address I
<br />JOB ADDRESS 5303 Be r +r- tLyY\ Dr I lOT # I
<br />SUBDIVISION I PARCElID#1 1~-;Up-1]- 0080- 00300-01~'D
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED B NEW CONSTR Ei2r ADD/ALT 0 SIGN D MOVE 0 DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE 0 SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL D OTHER I
<br />DESCRIPTION OF WORK I rllj olit Ale UN1 if
<br />BUILDING SIZE I SQ FOOTAGE I I I
<br /> HEIGHT
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />nz( MECHANICAL
<br />
<br />111111'1111'1.111'."111"'11"1'1'1111"1'..""1""""'111111"111,11111111111111111111111""1111"1111111111111'1111111""11""111'1.11111
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ ;;l. q 50 ' of) I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />1111111I1I1111I1111111111111II111I111I111111111111III11111111II11111111111111111111111111111I111II1111111111II1111111111I111111111I111111111111111
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />D
<br />
<br />WR.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />Address License #
<br />
<br />111111111111I11111111111I1111I1I1111111I11I1I11I1111I11I1111III111I111111111111I1111111I111I1I11111II111111111I111I111111111II111I11111111111II1I1
<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 on site, Construction Plans, Stormwater Plans w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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/ Silt 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 />
<br />Di~~~ii~~~': . . , , , , . . . . , , . . , , . , , , . . . . , , . . . , , . , . . , , . , . . . , , . . . . , , . . . . . . . . , . , . . , . , , , , . . . , , . . . , , . . . , , , , , . . , . . , , . , , , , . , . . , . . , , , , . . . . . , , , . , , , , , . . , . , , , , , , .
<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 Attomey(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 A1C Fences (Plot/Survey/Footage)
<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 />COMPANY
<br />REGISTERED
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />
<br />Address
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<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 />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />Y/N
<br />
<br />FEE CURRENT
<br />
<br />License #
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />License # I
<br />
<br />I ~i~'1 A~~aJ~'!'^~~i I
<br />License # I CAC05 gE 15
<br />
<br />Y/ N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
|