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<br />813-780-0020
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<br />City of Zephyrhills Permit Application
<br />Building Department
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<br />Fax-813-780-0021
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<br />JP,crlfP
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<br />Date Received
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<br />Owner's Name NHC-FL 11 5 LLC
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<br />Owner'sAddress 1~~~~t~n;~:~-L~~Ck R~~S~=~4~;j I U
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<br />Fee Simple Titleholder Namel
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<br />Fee Simple Titleholder Address
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<br />JOB ADDRESS 13751 Laurel Valley Blvn. Zephyrhi 1 ]!=l] PI. 11S40 LOT #
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<br />
<br />SUBDIVISION ~njP-!=lti c Onk!=l C.ommllni ly PARCELlD#I?4_?'h_?1_0010_0000o_ooro
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
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<br />SIGN D MOVE D
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<br />111.,111111
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<br />WORK PROPOSED
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<br />PROPOSEI) USE
<br />TYPE OF CONSTRUCTION
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<br />DESCRIPTION OF WORK
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<br />Owner Phone Number
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<br />Owner Phone Number 1
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<br />Owner Phone Number 1
<br />
<br />B
<br />D
<br />D
<br />
<br />B
<br />D
<br />D
<br />
<br />IXXJ
<br />D
<br />D
<br />
<br />DEMOLISH
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<br />ADD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />I
<br />D
<br />
<br />OTHER
<br />STEEL
<br />
<br />OTHER I
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<br />Install wiring from F.A.C.P. to new valve tamper switches.
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<br />SQ FOOTAGE I
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<br />HEIGHT I
<br />
<br />BUILDING SIZE
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<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />11111111111111'11"11111111111111"'11111111111111111111111111111111111111"'1"'..'111111"'111111111111'"1111"111111'...'1111111111""1111111
<br />
<br />1$ I
<br />1$ I
<br />. 1.225.00
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<br />1$ I
<br />1$ I
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<br />D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
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<br />11111111111111111111111111111111111111111111I1111111111111111111111111111111111111111111111I111111111111111111111111111111111111111111111111111111
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<br />D BUILDING
<br />liXJ ELECTRICAL
<br />D PLUMBING
<br />D MECHANICAL
<br />D GAS
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<br />AMP SERVICE
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<br />I:iXJ
<br />
<br />D
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<br />W.R.E.C.
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<br />PROGRESS ENERGY
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<br />VALUATION OF MECHANICAL INSTALLATION
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<br />BUILDER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />FEE CURRENT
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<br />Y/N
<br />
<br />Y/N
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<br />License #
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<br />
<br />IRTP-SP- Electrical, Inc.
<br />Y / N I FEE CURRENT I Y / N I
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<br />License # bc 1 3 0 0 1 3 5 3
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<br />Address
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<br />ELECTRICIA~~~
<br />SIGNATURE
<br />... --
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Zephyrhills, FL 33539 I
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<br />A~re" P.o. Box 862
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<br />PLUMBER
<br />SIGNATURE
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<br />COMPANY
<br />REGISTERED
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<br />Y/N
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<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
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<br />License #
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<br />MECHANICAL
<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 #
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<br />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Y/N
<br />
<br />Address
<br />1111111'1111111
<br />RESIDENTIAL
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<br />License #
<br />111111111111111111111111111111111111111111111111111111111I1I1111111111111111111111111111111111111111111111111111111 II 11II111111111
<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 w/ Silt Fence installed,
<br />Sanitary Facilities & 1 dumpster; Site Work Permit for subdivisionsllarge 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 on site, 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.
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<br />Di~~~ti~~~': ' , , , . . , , , , . . , , , , , , , , , , , , . , , , , . . . . , , , , , , , , , . . . . . . . . . . . . , , , . , , , , , . . . . . . . . . . . , , , , , , , , , , , , . . . . . . . , . . . . . . . . . . . , , . , . , , , , , , , , , , , , . . . . . . . . . , . . .
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<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)
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<br />Agent (for the contractor) or Power of Attorney (for the owner) would be someone with notarized letter from owner authorizing same
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<br />OVER THE COUNTER PERMITTING (Front of Application Only)
<br />Reroofs Sewers Service Upgrades NC Fences (Plot/Survey/Footage)
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<br />COMMERCIAL
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<br />SIGN PERMIT
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<br />Driveways-Not over Counter if on public roadways..needs ROW
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