|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Fee Simple Titleholder Address I
<br />K\ Q q \r\~ \U\ ~ \Jf\ Rt.
<br />
<br />Im~~L1 SQ~
<br />
<br />(]..A
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />~?- 0/ (
<br />~\~) f1 ~-Kl'\'\"\
<br />
<br />
<br />Owner's Name
<br />
<br />
<br />Date Received
<br />
<br />Fee Simple Titleholder Name
<br />
<br />SUBDIVISION
<br />
<br />
<br />l,
<br />D2- L-L'~D 'C\- O~qfu~QOW
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN 0 MOVE D
<br />
<br />LOT #
<br />
<br />JOB ADDRESS
<br />
<br />I
<br />
<br />
<br />E3 NEW CONSTR fX] ADD/All D
<br />INSTALL D REPAIR
<br />
<br />PROPOSED USE D SFR D COMM D
<br />
<br />TYPE OF CONSTRUCTION ~ ~LOCK . 0 FRAME 0
<br />
<br />
<br />DESCRIPTION OF WORK ~ ~
<br />
<br />
<br />BUILDING SIZE I I SQFOOTAGE~ I HEIGHT I I
<br />
<br />II I . 111 I I I , I I , I II , . I I , . I I I 1 . r I I , I II II r I II , . I I , , I , , II I I . I , I I I , II . I I , , I 1 , I III , I P , , I , I I I t ~ I I II I , I . I I , 111 I I I I I , , I III I I I I 1 I , . I I I 11 . I I I II I I I , I I 1 PI' I III ,
<br />
<br />o BUILDING 1$ 59; 7c() ~
<br />
<br />o ELECTRICAL 1$ 7 (!)~ ~ I
<br />
<br />o PLUMBING 1$ 2 750 ~~ I
<br />
<br />o MECHANICAL 1$ 36.5C] ~ I
<br />
<br />o GAS D ROOFING D
<br />FINISHED FLOOR ELEVATIONS I I
<br />
<br />DEMOLISH
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />o
<br />
<br />OTHER I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />AMP SERVICE
<br />
<br />D
<br />
<br />PROGRESS ENERGY
<br />
<br />D
<br />
<br />DYES
<br />
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />OTHER
<br />
<br />DNO
<br />
<br />BUILDER
<br />SIGNATUR
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~'~~~-I~
<br />
<br />
<br />License # I
<br />
<br />Hatf-,;" (lJ.C:tr'lU
<br />Y / N FEE CURRENT
<br />
<br />
<br />
<br />License #
<br />
<br />I Cc..L~DD J3,8~
<br />
<br />MECHANIC
<br />SIGNATUR
<br />
<br />I ~oto~Rookr
<br />I (yj N I FEE CURRENT I rJ,) N I
<br />
<br />License # I CFC 1"1267/~
<br />
<br />CO/'--! r
<br />
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<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 />I1111I111111111111111111111111111111111111111111I11111111111111111111111111111111111111111111111111111111111II1I1111111111I11111111111111111111I11
<br />
<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 wI 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 , , , I . , , , I . , , , I I , , , . , , I . , , , I I . . , I I , , . , I . . , I . . , . , , , , I . , , , , , I . . . , , . . I , , . . . I , I , , , , I . , . . . I . . . . , , , , , , I I . , . , , , , , , , , , , , . . I I . , I . . , . 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 />till .,.....\ .. ".':"
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|