|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />
<br />,nJ ,~L
<br />(!) ~ tC- c-R,"&.t:; T ivrJ V
<br />I
<br />
<br />
<br />Owner Phone Number
<br />
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Date Received
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />JOB ADDRESS SftM E.. LOT #
<br />SUBDIVISION I PARCEL ID#I 02, - 2/p-21- b ~10 - ()O{XJO - O() C( ()
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />WORK PROPOSED (g] NEW CONSTR ~ ADD/ALT 0 SIGN 0 MOVE 0 DEMOLISH
<br /> INSTALL REPAIR
<br />PROPOSED USE cgJ SFR D COMM 0 OTHER I
<br />TYPE OF CONSTRUCTION 0 BLOCK D FRAME 0 STEEL 0 OTHER I
<br />DESCRIPTION OF WORK 10;41l-1'\J (P!L WT "2 '/2- -rt'~ I4/C l//vj'r
<br /> I
<br />BUILDING SIZE SQ FOOTAGE I I HEIGHT
<br />
<br />11111111,,111'1111111'11111'11"11'111'1""111,""1111"1'111111'111111'1111'11'111111"1'11'1111111"'111'IIII'IIIIP'IIII,IIIIIIIIII'IIIIIIIIII
<br />
<br />D BUILDING
<br />D ELECTRICAL
<br />D PLUMBING
<br />~ MECHANICAL
<br />
<br />1$ I
<br />1$ I
<br />1$ I
<br />1$ t.f\;:SOD' r.t!Z- I
<br />
<br />D GAS 0 ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />111I11I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />W.R.E.C,
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />BUILDER
<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 />ELECTRICIAN
<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 />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANIC
<br />SIGNATURE
<br />
<br />
<br />License #
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address License #
<br />
<br />11I1111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111111I11I111111111111111111
<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 onsite, 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 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~~~ti~~~':' , . , . . , , , . . , , , . , , . , . , . . , , , . . , , . . . , , , . . . . , , . . , , . . . , , . . , , , . . . . . , . . . . , , . . . , , . . . , , , . . , , . . . . . . . . , . . . . . , . . , , , . . . . . , , , . . . . . , . . , . . . . . . . . , . , , . , I
<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 (Plot/Survey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|