|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-S1 ~-780~0021
<br />
<br />Date Received
<br />
<br />
<br />Owner's Address
<br />
<br />
<br />Fee Simple Titleholder Namel
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Name
<br />
<br />Fee Simple Titleholder Address
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />'z-/4,'Us FlA. d3~t.{ { I LOT# I
<br />
<br />PARCELlD#1 ~S... J-5 -2( -oD/o - 10.500 -0000
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />SIGN D MOVE D
<br />
<br />JOB ADDRESS
<br />
<br />YoSo 6,<:JJ...L- f3wdL
<br />
<br />
<br />~
<br />D
<br />D
<br />A
<br />
<br />I
<br />6
<br />D
<br />D
<br />
<br />AOD/ALT
<br />REPAIR
<br />COMM
<br />FRAME
<br />
<br />DEMOLISH
<br />
<br />SUBDIVISION
<br />
<br />WORK PROPOSED
<br />
<br />OTHER
<br />STEEL
<br />
<br />1$11~1L r/l./I.
<br />D OTHER I
<br />
<br />I?uJ /...-12 01 Lr
<br />
<br />BUILDING SIZE
<br />
<br />1111 " 111111111111 , II I III 111 , ,. II , 1111111111111 , , , . I III " II , , I III r I II , , , I 1III , , III , . I II , 1111 . 1111 , , . III ,. . 111 , III II III , . 11" III , IIIII r . 11111111 I II
<br />
<br />czj
<br />
<br />BUILDING
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<br />
<br />ROOFING
<br />
<br />D
<br />I
<br />
<br />SPECIALTY D
<br />FLOOD ZONE AREA
<br />
<br />
<br />D
<br />
<br />W.R.E.C.
<br />
<br />D ELECTRICAL
<br />ITf PLUMBING
<br />cri MECHANICAL
<br />
<br />AMP SERVICE
<br />
<br />VALUATION OF MECHANICAL INSTALLATION
<br />
<br />OTHER
<br />DYES
<br />
<br />DNO
<br />
<br />:~~~~~RE ktff~(,~~~
<br />
<br />Address
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />~ECHANICAL
<br />r SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />License # I e6~ tJ60 C? I( h I
<br />
<br />1f:~(i:f~~'C' I Y/N I ~:t'''
<br />
<br />License # I ~{JOC)O .AI fib' I
<br />
<br />6hv/~ I-. ~
<br />FEE CURRENT Y I N
<br />
<br />License # I~~~ Pl.:}. 71/;;;8
<br />
<br />I /f1J65-Y ~d/; f'o'~r7NY
<br />_Y / N _ FEE CURRENT I / N~
<br />
<br />License # I
<br />
<br />Address
<br />
<br />w;* /J II /vo
<br />
<br />lJ:tJ;,( ~/4L/2-u
<br />
<br />Be,,) t'?/-}/3JbERUA AI/~ ..2-)/,tL.,
<br />
<br />~~~
<br />
<br />,
<br />
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />
<br />Address
<br />
<br />Address
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />OTHER
<br />SIGNATURE
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />COMMERCIAL
<br />
<br />License #
<br />
<br />1111111I111111111111111111111111111111111111I11111111111111111111111111111111111I1111111111I1111111111111111111111111I11I111111111
<br />
<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 subdivlsions/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 />i:il~~~ti~~~':' , , , , , , , , , , , , , , , , . , , , , , , . , , , , , , , . , , , , , , , . , , , , , , , , , , , , , , , , , , , , . , , , , , , , , , , , , . , , , , , , , " ' , , . , , , , , , , , . , , , . , , . , , , , , , , , , , , , , . , , , , , , , . . , , , , , , , , ,
<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 />SIGN PERMIT
<br />
<br />Driveways-Not over Counter if on publiC roadways..needs ROW
<br />
|