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' 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> : Building Department
<br /> Date Received = = f s, > , .�._.. .,< - -,.,.
<br /> ��_• Phone.Contact for Permittin
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<br /> Owner'§Narr(e: -;r; `'� ;�,` Owne"r Phone,Num6er-':,' ;:�` T f _ .1 �'; "
<br /> t . i ' �t -, .�.'.' �.. � � �,� . l� !`•�':•'�:. - �i_Y:{� . _,
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<br /> Owner's-Address'� ^°��'�`��'"'(`��" , Owner Phone�Number � ~�~ ��
<br /> Fee Simple Tltleholder Owner Phone Number �
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<br /> Fee Simple TitleFiolder Address., _ ` �,
<br /> JOB ADDRESS � LOT# �
<br /> SUBDIVISION "PARCEL�ID# ' �
<br /> (08TAINED FROM PROPERTY TAX NOTICE)
<br /> , WORK PROPOSED e NEW CONSTR e '�ADD/ALT Q SIGN` Q �Q DEMOLISH �
<br /> INSTALL. �REPAIR
<br /> PROPOSED USE � Q SFR Q COMM 0 OTHER
<br /> TYPE OF CONSTRUCTION �Q BLOCK Q FRAME � STEEL Q
<br /> DESCRIPTION-OF VIIORK '
<br /> BUILDING SIZE' $Q FOOTA E . �, HEIGHT �
<br /> OBUILDING $ • QQ z VALUATION OF TOTAL CONSTRUCTION
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<br /> QELECTRICAL $ ' -AMP SERVICE Q ' PROGRESS ENERGY -�Q W.R.E.C.
<br /> QPLUMBING $ �3
<br /> 1��
<br /> QMECHANICAL $ VALUATION OF MECHANICAL-INSTALLATION ''P
<br /> QGAS Q ROOFING. .Q SP,EC�AITY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Li6ense�# � ' �
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<br /> ELECTRICIAN� � COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/'N
<br /> Address � � - License#� -
<br /> PLUMBER , COMPANY -
<br /> SIGNATURE _ REGISTERED. Y/ N , FEE CURRE�', , Y/:N
<br /> Address � ' ,License#,
<br /> MECHANICAL �' � COMPANY .
<br /> SIGNATURE " ` ; � REGISTERED ,Y/.N. FEE CURRE� Y/N-
<br /> Address. ' - -� 'cense#
<br /> OTHER COMPANY
<br /> SIGNATURE ��� ' REGISTERED " Y/ FEE CURRE� Y/N.
<br /> Address „;�� �- � -- � - ; 'L'icense# �- - - -
<br /> RESIDENTIAL-y ,, Attach(2)Plot:Plans;(2)setsof Building�P..lans;'(1):seYof Energy�Forms;R-0=1N•Perrnit for new construction, � "
<br /> � , �Minimum ten;(.10);,working.days�,after=submittal;d'ate:'Reguired bnsife;:Construction"Rlans;StoRnwater'Pians w/Silt Fence installed,
<br /> �Sanitary FaGliUes 7&;,1 dumpste,r,•SIte;lNorii<Permit�,for�subdiyisions/large;projects,„ �' ' �
<br /> COMMERCIAL Attach(3)co'mplete�sets of`Building Plans plusa�Life Safety Page;`(1)set of Energy Fortns.R-O-W Permit for new constructlon.
<br /> Minimum ten{10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitfes&1 dumpster.Site Work Pertnit for all new projects.•Ali�commercial requirements must meet compliance
<br /> 51GN PERMIT Attach•(2)sets�of Engineered,Plans. ".";�., ,_:-. =�_ , , , .
<br /> ""PROPERTY SURVEY required for�all�NEW construction: . , __ .
<br /> �irections: � .,:, .;, . ,
<br /> Fill out application completely.
<br /> Owner 8 Contractor sign back of applicatlon,notarized
<br /> If over a2500,,a Notice of Commencement Is 'required. (A!C upgrades over;7500)
<br /> " Agent(for the contractor)�o�Power of Attomey(forthe�owner)would be"someone with notarized letter from owner authorizing same
<br /> �VER.THE COUNTER_PERMI7TING,. _.._,,,(Front.of.Application..Only) ' � `
<br /> �eroofs if shingles 8ewers Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> Driveways-Not over Counter if on publtc roadways':rieeds"ROW
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