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813-TSO-Q020 City of Zephyrhills Permit Application �ax 813-780-0021 '
<br /> ._ __,........,..,:_,.,.,�_.,��..�„P��,,,w. Building Departiment
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<br /> Date Received. �.h�,,, ` ' _ '`� ' � Phone Con'tact for Parmittln 1 . _ .�.. .. �}�� . � � y. �
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<br /> Owner's Name,. . .�, :�,V.�J..' .,.,t ��� � li 'LL� `, C�rntne�Phone_NumiierR•_ f.,j , � "�
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<br /> Owner's Address . � �� � Ow�er Phcn�Ftnri►6er �
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<br /> Fee Slmple Tltlehalder Name;- QwnenRhone.Number��;�
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<br /> Fae Stmple Tilleliolder Address I
<br /> JdB ADDRESS �-J 7 G' -�-'��` LOT# �__,�
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<br /> SUBDIVtS10N �— ---� PARGEL ID# � � -�.rj"��-�`"'���L%-� r�C>�
<br /> { {OSTA4NED FROM PROPER7Y TAX NOTtCE)
<br /> WORK PROPOSEQ NEw CONSTtt ApQ/ALT C� SIGN Q [� DEMOCtSH
<br /> � INSTALL 8 REPAIR �
<br /> PROPOSED USE Q SFR Q COMM � OTHER
<br /> TYPE OF CON3TRUCTION Q BLOCK �Q FRAME � STEEL Q
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<br /> DE3CRIPTION OF WORK (..�' C �- � ��l!\�L.` '� I L�C�b��✓� •'`�
<br /> BUi�DING S1ZE SQ F001'AGE��_� � HEIC�HT C��
<br /> [�BUILDING � —� VAIUATION OF TOTAL CONSTRUCTION
<br /> ELECTRICAL $ % � AMP SERVICE f p� Q ���ROGREBS EfdEf2GY Q W.R.E.G.
<br /> 7.�
<br /> [�PLUMBIN(3 r$ —�� �����
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<br /> [�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> 1
<br /> ' QGAS Q ROOFING CJ SPECIALTY [.'I� OTHER
<br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE Ai EA QYES NO
<br /> BUILDER COMPANY
<br /> SIGMATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � License# i �
<br /> ELECTRICIAN � COMPANY . � C Cd �.? 'c• , �.,t�'�(7 N(
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<br /> SIGNATURE � F2EGISTERED I N FEE CURRE� Y/N
<br /> Address v�� f 1C � `���� Cicense# t= � ��ft� (��� �
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGI$TERED Y/ N FEE CURRE� Y/N
<br /> Address �Icense# � �~�
<br /> MECHANICAL � COMPANY
<br /> SIGNATtlRE REGI3TERED Y/ N FEE CURRE� Y/N
<br /> Address 1.icense# �—� i�
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ i� FEE CURRE� Y/N.
<br /> Address , l.Icense#�� �
<br /> RESiDEN7iA1: Attach(2)Rlot P1ans;(2)sets of Bullding Plans;(1)set of EnergyForms;R-C1-W Permit for new construction,
<br /> Mintmum ten(1dj wartcing days.aftec.submittal date. Requlred onsite,.Construc�tEan Plans,Stortnwater Ptans w!Sitt Fence instalted,
<br /> Sanitary Facilifles 8�1 dumpster,Slta Work Pert»it for subdivislons(large proje�ts -
<br /> COMMERCIAL Attach(3)�complete sets of Bullding Plans plus a Llfe Safety Page;(1)set of Energy Forms.R-Q-W Permit for n�w consUucUon.
<br /> Minimum ten(1d}wartcing days after submittal date. Required.onsite,GanstrucNan Plans,Stormwater Pisns w/Sitt Fence Instatled,
<br /> Sanitary Facfli8es&1 dumpster.Site Wotk Permit for all new pr+�a}ects.All commercia!reqniremeats must mest c�mpliance
<br /> SIGN PERMIt Attach(2)sets of Engineered Pians..
<br /> •*"'PROPERiY SURVEY required for alt NEW construction.
<br /> Dlrectlon�: i
<br /> Fi{I out applica�an completely. �
<br /> Owner&Contraator slgn back of applicaUon,notarized
<br /> If over�2500,a Notice of Commencement la required. (AIC upgrades over ST500)
<br /> " Agent(for the contractor)or Power of Attomey(for the oumer)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITI'ING (Front of ApplicaUon Only) {
<br /> Reroofs if shingtes Sewers Service Upgrades NC Fences(Ptot/SurveylFootage}
<br /> Drivewaya-Not over Counter if on public roadways..naeds ROW
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