|
<br />813-780-0020
<br />
<br />City of Zephyrhills Permit Application
<br />Building Department
<br />
<br />Fax-813-780-0021
<br />
<br />Date Received
<br />
<br />
<br />
<br />Owner's Name
<br />
<br />2 . fit '/k
<br />
<br />Owner Phone Number
<br />
<br />Owner Phone Number I
<br />
<br />Owner Phone Number I
<br />
<br />Owner's Address
<br />
<br />/7Jd,.~~~
<br />f1ee Simple Titleholder Name
<br />
<br />T-9/15r..r1"....lt;,., ...
<br />
<br />~"tJ:2... /1-, 'r- for'" ;fd.
<br />
<br />Fee Simple Titleholder Address I
<br />JOB ADDRESS I 5'iJ12 4,,'/NJ eRe!
<br />I
<br />
<br />WORK PROPOSED
<br />
<br />E3
<br />D
<br />D
<br />
<br />NEW CONSTR
<br />INSTALL
<br />SFR
<br />BLOCK
<br />
<br />2~l;r),;-/h F/.,J3:5-<l~ LOT #
<br />
<br />I PARCELID#I/;2-,2, -;2I.../~~t!J-,1 Y'1/J~- "0 It)
<br />(OBTAINED FROM PROPERTY TAX NOTICE)
<br />c-l ADD/ALT D SIGN D MOVE D
<br />D REPAIR
<br />D COMM D
<br />D FRAME D
<br />
<br />SUBDIVISION
<br />
<br />DEMOLISH
<br />
<br />PROPOSED USE
<br />TYPE OF CONSTRUCTION
<br />
<br />OTHER
<br />STEEL
<br />
<br />I
<br />D
<br />
<br />OTHER I
<br />
<br />
<br />DESCRIPTION OF WORK ~/r"'c f Cd~ 2-;'Pu h.e/:'!f""51U<(" ("j,. & (,r€-eMc,,7. -JI. l-/Ll- tJt-o 3(,t
<br />
<br />BUILDING SIZE SQ FOOTAGE I HEIGHT I
<br />TTfTTTllllll . . , I , , , 11II11111 , . , , I . II111111 . . I , 1I11 , , I , 111111111111111 . . I , 111I1 ' . . , . . I . II , 111II111 . . , , 11111 . . , I . , , 11111111111 . . I . 11I1I11111 r I . 11111
<br />
<br />D
<br />
<br />BUILDING
<br />
<br />1$
<br />
<br />I
<br />m ELECTRICAL I~oo ,.... I
<br />
<br />D PLUMBING 1$ I
<br />
<br />D MECHANICAL 1$ I
<br />
<br />o GAS D ROOFING D SPECIALTY D OTHER
<br />FINISHED FLOOR ELEVATIONS I I FLOOD ZONE AREA DYES DNO
<br />IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII!IIIIIIIII11I111I111111111111111111111111111111111111111111111111111I11111111111111111111111111111111I
<br />
<br />VALUATION OF TOTAL CONSTRUCTION
<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 />
<br />7
<br />
<br />
<br />s/l1f3:f
<br />
<br />
<br />BUILDER
<br />SIGNATURE
<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 />
<br />hHIC" E/<"cfYlc
<br />I Y I N I FEE CURRENT
<br />
<br />Y/N
<br />
<br />ELECTRICIAN
<br />SIGNATURE
<br />
<br />~~;na/
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Address
<br />
<br />335>-'10
<br />
<br />License #
<br />
<br />PLUMBER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y / N FEE CURRENT I Y / N
<br />License # I EC -Oc:)/.Z~~
<br />
<br />Address
<br />
<br />zro?37
<br />
<br />MECHANICAL
<br />SIGNATURE
<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 />OTHER
<br />SIGNATURE
<br />
<br />COMPANY
<br />REGISTERED
<br />
<br />Y I N
<br />
<br />FEE CURRENT
<br />
<br />Y/N
<br />
<br />Address
<br />111111111111111
<br />RESIDENTIAL
<br />
<br />License #
<br />11I11111111I1111I111111I111111I111111111111111111111111111111111111111111111111111111111111111111111111111111I1I1I11I1111111111111
<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 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 />COMMERCIAL
<br />
<br />SIGN PERMIT
<br />
<br />1111111,..........,1.,111.....,11..111...............,...."..."...,............,1....,...1...............1..1..............................,....
<br />Directions:
<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 (PloUSurvey/Footage)
<br />
<br />Driveways-Not over Counter if on public roadways..needs ROW
<br />
|