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a��-,a���V C:ity of Zephyrhills Permit Application Fax-s�aasa-ooz�
<br /> • Building Department
<br /> Date Recetved Phone Gontact for Permitting ,,jr� � - � �
<br /> Qwner's Name 6� �' Owner Phone Namber yQ �'�a�� �,5�6 t�/ �
<br /> Owner's Address �(,.J , /` Owner Phone Number �— �
<br /> Fee Simpte Titlehoider Name � � Ov�ner Phone Number �� � �
<br /> Pee Simple Tltiehotder Address
<br /> JOS ADD}2ESS tF 7�� �`jt��. LOT# Q
<br /> SUSQlV13lON �.�!/,�:�-��1�� PARCEL 1D# O�� G+C � �OC ���� LJ "`�d�t��� �t���
<br /> (OBTAINED FROM PROPER7Y TAX NOTICE}
<br /> ' WbRK PROPbSEb e NEW CONS7R 8 ADDlALT � SIGN Q Q DEMCAISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE OF GONSTRUCTION Q BLOCK Q FRAME �,] 5TEEL Q �
<br /> DEBCRIPTION t}F itVCtRK ,(/�{� l �j� `
<br /> , - ,..
<br /> BUlLDlNG SIZE �`Y1 SQ FOOTAGE HEIGHT ��
<br /> QBUILDING $ �
<br /> VALUATIQN OF TOTAL GONSTRUCTIQN
<br /> [� �cLECTRICAL [96 � AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
<br /> `
<br /> QPLUMB�NG $
<br /> ,�..`.._�
<br /> MECMANtCAL $1� /�^- VALUATION OF MECHANICAL INSTALLATION
<br /> l �iaJ � �
<br /> [�GAS Q RQOFING _Q SPECIALTY � OTHER
<br /> FiNISHED FLOOR ELEVA710NS �� FLOOD ZQNE AREA QYES NO
<br /> BUILDER COMPANY
<br /> i SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address license# �� � �I
<br /> ' ELECTRICIAN COMPANY
<br /> StGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> , Address i.icense# � i�
<br /> PLUMBER � COMPANY
<br /> SIGNATURE REGISTERED Y/ N pEE CURRE� Y/N
<br /> Addr�ss License# �— �
<br /> �
<br /> MECHANICAL ,� COMPANY �' ��
<br /> SIGNATURE c.,•� REGtSTERED / N FEE CURRE� N
<br /> AddrASS R.icense# �� ��
<br /> 4THER COMPANY
<br /> SlGNATURE REGIBTERED Y I �! FEf CURRE� Y/N
<br /> Address License# �— —�
<br /> RESlDENTIAL Att�tch(2)Ptot Plans;(2)sets of Suilding Pians;(1)set of Energy Forms;R-O-W Permit for new canstruction,
<br /> Minimum ten(1Q)warking days aRer subm3ttal date. Required onsite,Construc8ori Pians,8tormwater Pians w!Sitt Fence installed,
<br /> San(tary Faoilities&1 dumpster;S1te Work Petmit for subdivisiansRarge projects
<br /> COMMERCIAL Attacfi(3}comptete sets of Buttding Plans plus a Life Safety Page;(1)set of Energy Farms.R-O-W Permit for new construcUon.
<br /> Minlmum ten{1U)worlcing days after submittaf date. Required onsite,Construction Plans,Starmwater Plans wl Silt Fence installed,
<br /> Sanitary Faoilitles&1 dumpster,Site Work Permit for al!new proJects.A!!commerefat requfrements musi meet compt3ance
<br /> S1GN PERMIT Aftach(2)sets of Engineered Plans.
<br /> ""PROPERTY SUR1tEY reqnEred far ail NEW construction.
<br /> Directions:
<br /> Ftli aut appllcation completely. , - � -
<br /> Owner&Contractor sign back of applieation,nota�ized ; ' � - '
<br /> if over a2500,a Notice of Commencement Is requlred, (AJC upgrades o�rer$7500� 4 f,,_ '';
<br /> ., - � • , . . _ ,�.. :
<br /> Agent(for the contractor)or Power of Attortiey(for the owner.)would.be someone wifh notarixed letter from owner authoriz+ng same '
<br /> DVER THE COUNTER PERMI7TING (Front of Applicatian Only), .,. .„ ...,..__,�. .., ..,...:...,..,,___,.,,,..;,__ ,� �
<br /> Reraafs ff shingles Sewers -Serotoe�Upg�ades,'A7C Fences�(PIatJSurveylFootage) � . ' � , -
<br /> ,' _' '_` � , � , _. , " `
<br /> :. .,;, _ ,
<br /> Drlveways-Not over Caunter if on public,roadways::needs ROW , _ , = � ' _ `
<br /> . . - . ., rn..3.-..w..� ._ -.. .. . . ,1_._._.�.. ... . .......s...�. .c<.......,. -.-.,.
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