|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />mO^Ou...cs[~s
<br />(Y..--, U,;;.. ~
<br />
<br />Date Received
<br />
<br />\\- ~-()
<br />
<br />
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />.....1.....
<br />
<br />
<br />(ZJ. ,4
<br />C,:,,- ~/,:f-l'/ ~1Psf Lt:?~~i?1
<br />I
<br />
<br />/ Owner's Name
<br />I'" c' (-;7 ,//1
<br />/" Owner's Address --:) 0 t' T
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Fee Simple Titleholder Address
<br />
<br />,/ JOB ADDRESS
<br />
<br />~
<br />~/l/l1~ c;;...s:
<br />
<br />/
<br />({be? ,,/E
<br />
<br />LOT #
<br />
<br />PARCEL ID#I
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />B
<br />D
<br />D
<br />
<br />SUBDIVISION
<br />
<br />". DESCRIPTION OF WORK
<br />
<br />~
<br />
<br />PROPOSED USE D
<br />TYPE OF CONSTRUCTION D
<br />
<br />~r5TA.l4'
<br />
<br />BUILDING SIZE 1$ / ;:>< 20 / I SQ FOOTAGE HEIGHT I
<br />I I I I I I I II I I I IIII I I I II I I I II I II II I I I II I I I IIII I I I I II II I , , I I I . I I I I II I I I II I I I II I I I I IIII I III I I I I I I I I I II I I I I I III , II I I I I I III I I I III , , I , I , II IIII II I II (fTTTTT
<br />D BUILDING ~ 1$ /5 CJ t/~ dO I VALUATION OF TOTAL CONSTRUCTION l
<br />
<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />D
<br />D
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />//
<br />
<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 />SPECIALTY D OTHER
<br />FLOOD ZONE AREA DYES
<br />
<br />DNO
<br />
<br />
<br />
<br />'~
<br />COMPANY ~ Q)'1&..1"~
<br />REGISTERED Y I N I FEE CURRENT Y I N
<br />
<br />I License # I
<br />
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N FEE CURRENT
<br /> License #
<br />Y I N FEE CURRENT
<br /> License #
<br />Y I 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 />11I1111111111111111111111111111I1111I1111111111111111111111111111111111111111111111111111111111111111I11111111111111II111111I11111
<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 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, 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 />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 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 AlC Fences (Plot/Survey/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 />
|