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<br /> � 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department _. , ,...,<__.. .,., ..., . ,._�.�_..... :
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<br /> Date Recelved '>' •�:.. . �- .. �,:i ,'�. :. .,���J. :� O. �; - �"t s�
<br /> �Phone-Contact for Permitting�'
<br /> � i,'; � �. �„ :;-<�,-..,._.- � � --� — � /
<br /> Owner's Name -�' � �� `L�1 S� 0� � �'�' Ownee Phone Number� v
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<br /> Owner's Address `•. •- `d_�-�`�. . W�.'tT- � � A ��•Owner Phone Number-----...
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<br /> Fee Simple Tltleholde�yName,. � `� ' ��Own�er Phone Numlier
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<br /> Fee Slmple Tltleholder Address � '
<br /> JOBI4DDRESS "i'� {' I I� �� � I !►��1�15 ��— ��� , :—L07'#__ �
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<br /> SUBDIVISION PARCEL ID# I; � 3 'Z6 ' Z�'"O` OO 'O - Q f�
<br /> I (OBTAINED FROM PROPERTYTAX N TICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT IQ SIGN Q Q DEMOLISH
<br /> � e INSTALL B REPAIR 1
<br /> PROPOSED USE Q SFR �]] COMM IQ OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q �
<br /> DESCRIPTION OF WORK 0.G1� � � � � Il S ` ' � ��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING � $ `6�3�0
<br /> 51�0�V�� VA A I OF MECHANICAL INSTALLATION �
<br /> QMECHANICAL $ �v��fV
<br /> 1
<br /> QGAS Q ROOFING SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS , FLOOD ZONE AREA QYES NO
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<br /> BUILDER COMPANY
<br /> SIGtdATURE REGISTERED Y/ N FEE CURRE� ,Y/N
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<br /> Address Lfcense#
<br /> ELECTRICIAPI COMPANY '
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
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<br /> PLUMBER CONEPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address I - License# � '
<br /> MECHANICAL t,( � ( G� COMP� �£S t ��;,�)'yl � /yj �L
<br /> SIGNATURE L "r� � ` REGISTERED Y/ N FEE CURRE� Y/N
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<br /> � IAddress License#
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<br /> OTHER ' COMPANY
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N.
<br /> Address ( License#
<br /> RESIDENTIAL Attach(2)Plot Plans;,(2)sets of Building`Plans;(1.)set of Energy�Forms;R-O-W Permit far new construction,
<br /> . Minimum ten(10)working days after subrriittal date. Required onsite,ConsWction Plans,�Stormwater Plans w/Silt Fence installed,
<br /> SaNtary Facilities&1 dumpster,;Site•Work Permtt for subdivisions/Iarge�proJects '
<br /> COMMERCIAL Attach(3)complete sets of Builtling Plans plus a L(fe Safety Page;(1)set of Energy Forms.R-O-W Permit for new consUuction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Siit Fence installed,
<br /> � Sanitary FaciliHes&1 dumpster,Site Work Pertnit for all new projects.All commercial requlrements must meet compliance
<br /> SIGN PEI�MIT Attach(2)sets of Engineered Plans.., � • •
<br /> ""PROPERTY SURVEY required for all`NEW construction.
<br /> Directlons: .
<br /> Ffll out applicadon completely.
<br /> Owner&Contractor sign back of appl(caUon,Kotarized °
<br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over E7500) ,
<br /> '" Agent(for the contractor)or Power of Attomey(for tFie owner)would be so�eone with notarized letter from owner authorizing same '
<br /> DVER THE COUNTER PERMITTING -,--f�ren!-o tion Only) �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) �
<br /> Driveways-Not over Counter if on public roadways..needs ROW
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