|
<br />813-780-0020
<br />
<br />Date Received
<br />
<br />
<br />Owner's Name
<br />
<br />Owner's Address
<br />
<br />Fee Simple Titleholder Name
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />
<br />Cf-
<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 />
<br />I ~ [ol
<br />I
<br />
<br />/'+D { I '1
<br />
<br />JOB ADDRESS
<br />
<br />ct-
<br />I
<br />B
<br />D
<br />D
<br />
<br />LOT #
<br />
<br />SUBDIVISION
<br />
<br />PARCELlD#lo L. - '2-- \P - L J - 0"7.... J G - 600 () 0 - l'f/U
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />DEMOLISH
<br />
<br />BUILDING SIZE I SQ FOOTAGE I /00 tJ HEIGHT I
<br />1111111111111111"1111111111111111""'11111111'1111"1111111"111111"'1111111111'1111111111111111"111111111"1111111'11111111111111"1111111111
<br />
<br />I
<br />I
<br />I
<br />
<br />o MECHANICAL C I VALUATION OF MECHANICAL INSTALLATION
<br />
<br />D GAS ~ ROOFING D SPECIALTY 0 OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII1111I1111I111111111111111111111111111I111111111111111111111111111111111111111111111111111111
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />I
<br />..4? c I
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />B
<br />D
<br />D
<br />Ik
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />(o~f
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />DESCRIPTION OF WORK
<br />
<br />o
<br />
<br />BUILDING
<br />
<br />1$ 3l '2..0 I" DC>
<br />1$
<br />1$
<br />
<br />o
<br />o
<br />
<br />ELECTRICAL
<br />
<br />PLUMBING
<br />
<br />BUILDER
<br />SIGNATURE
<br />
<br />D
<br />D
<br />D
<br />
<br />ADD/AL T
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />o
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />PROGRESS ENERGY
<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 />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Address
<br />
<br />License #
<br />
<br />MECHANICAL
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y/N
<br />
<br />Y / N
<br />
<br />FEE CURRENT
<br />
<br />Address License # I
<br />
<br />OTHER ~. ..~./.....< J COMPANY IJ~~~d}<-t q",,~h;..)
<br />SIGNATURE ~ ~ REGISTERED I Y / N I FEE CURRENT I --.y / N I
<br />
<br />Address I P b r(3c>,k / /" ~ 6' tl- ~ fr-nr. .T3c;-74 License # I LCCO~77s 7
<br />
<br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111I1111I1111111111111111111111111111111111111111111111111111111111
<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 onsile, Construction Plans, Stormwater Plans w/ 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 />COMMERCtAL
<br />
<br />SIGN PERMIT
<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 />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|