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<br /> ��saso-oozo City of Zephyrhills Permit Application F�s�a-TSaoo2�
<br /> ' Building Department
<br /> Date Recelved a Phone�Contact for Permtttin —
<br /> �
<br /> Owner's Name c%' Owner Phone Number
<br /> r-'' �
<br /> Owner's Address �� Owner Phone Number �
<br /> Fee Simple Tltleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � �d T(�l U LOT# ��
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL e REPAIR
<br /> PROPOSED USE Q SFR [] COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK �'h T�C� t9v � �
<br /> BUILDING SI2E SQ FOOTAGE�� HEIGHT
<br /> QBUILDING $ VALUATION`OF TOTAC CONSl'RUCTION
<br /> ELECTRICAL $ �j�_,� � AMP SERVICE��v PROGRESS ENERGY Q W.R.E.C.
<br /> �V �
<br /> OPLUMBING $ ��C,�j
<br /> � � �� o
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO I
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addreas License#
<br /> � / �/' �
<br /> ELECTRICIAN � COMPANY �C�c �I�C U�c'
<br /> SIGNATURE � REGISTERED Y/ FEE CURRE� Y/N
<br /> Address l License# ^ .�'d0 c� �, �
<br /> PLUMBER COMPANY
<br /> SIGNATURE - REGISTERED Y/ N FEE CURREA Y/N
<br /> Address License#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED - Y;/ N , FEE CURRE� Y/N
<br /> Addre�� License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N-. FEE CURRE� Y/N
<br /> Address - License#
<br /> RESIDENTIAL. 'Attach(2)Plof Plans;.(2)sets of:Building�Plans;(1)sef of Energy�Forms;R-O-W Pertnit for new construction,
<br /> Minimum;ten.(10)wo.rktng�;days after subinittal date. Required onsite,Constr�ction Plans:Stortnwater Plans w/Silt Fence installed,
<br /> Sanifary Facilides:&-1�dumpster Site Work�Permit#or subdivisionsAarge proJects
<br /> COMMERCIAL Attach(3)complete sefs of Building Plaris plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes 8_1�dumpster.Site Work Permit for all new proJects.All commercial.requlrements must meet compliance
<br /> SIGN PERMIT Attach"(2)sets of Engineer,ed Pians..,.- ,._°� "
<br /> ""PROPERTY SURVEY required for all NEW.construct(on.
<br /> Directlons: , ',
<br /> FIII out applicadon completely. ' . , �
<br /> Owner 8 Contractor stgn back of applicaUon,notarized �` ' ' ? '; �
<br /> If over 52500,a Notice of Commencement is required:- (AIC upgrades oyei;�7500) - --� _, ..% - , _
<br /> " Agent(for th'e contractor)or'Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITTING (Front of Application Only)�. �- =-z��-��°�''�.�"' ; ° �• }� � r=..�.. -_� __-.:�. _..,,,..,,. '
<br /> Reroofs ifshingles Sewers Service Upgrades A/C,. ;Fences'(RIoUSurvey/Footage) � � � "' -- � � �
<br /> '�- -� `� . , , , .
<br /> ,..;_. S. _ ;ti; ,. ,.�:,,� - - .; ,. . .
<br /> Driveways-Not over Counter if an public roa'dways..needs RO.W.:^, "��, � � - - �,: �' - ' . , - - �:
<br /> „ , � _ .. ;,, � . , „ . . .. �
<br /> a . _1� .��. ._.,_.. : ._,..... . . .. .:... . .. r. . ::,�, .� ._._. -�-, ..._.. _ . . ..
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