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�813aao-oo2o City of Zephyrhills Permit Application Fax-813aeo-oo7�
<br />� ' Bullding Qepartment
<br />� Date Received �
<br /> Phone Contact far Permi#in -
<br /> Owner's Name 4wner Phone Number �rc�-O� 7- t�"j l
<br /> Owner's Address �� � �� Owner Phone Numbsr � - ,� �
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<br /> Fee Slmple Tltleholder Name r� • � Owner Phone Number �� � ,
<br />, Fee Simple Tltlaholder Address
<br /> JOB AbDRESS /,j`1� T S �C� V� LOT# [�
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<br /> SUBDIVISION l 'i.��� PARCEL ID# 3'�°�`�" °��" 4�$�-�Da OD -.O 3�"�
<br /> (QBTAINED FROM PROPERTY TAX NOTtCE)
<br /> WORK PRBP{.1SED NEW CONSTR ADD/ALT � SIGN� � DEMOLISH
<br /> INSTALL e REPAIR
<br /> li PROPOSED tISE Q SFR � CQMM � OTF{ER (
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<br /> TYPE QF CONSTRUC170N Q BLOCK � Q FRAME � STEEL Q i
<br />' pE3CRIPTION OF WORK C'� mD 2t� � �I �G�}-� �C U/ � (a�- "�
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<br /> BUiLDING S1ZE ��l���_..`J SQ F007AGE C� HEIGHT _„�_„�
<br /> BUIl.DING $� �y�� �''
<br /> � VALUATION OF TOTAI.CONSTRUCTION
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<br /> QEIECTRICAL $ � AMP SERt/iCE Q PROGRESB ENERGY Q W.R.E.C.
<br /> OPLUMBING � � ���
<br /> �MEGNANICAI �s-�. VALUATIQN OF MECHANICAL tNSTAE.LATION � ,y I
<br /> QGAS Q ROOFiNG Q SPEClA�TY � OTHER
<br /> FINISHED FLOOR ELEVATIQNS �� FLQOD ZQNE AREA QYE� NO
<br /> BUtIDER � COMPANIf („� '
<br /> SIGNATURE �-� REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address L:icense# � �
<br /> E�EC7'RtClAi11 .� COMPANY
<br /> SIGNATURE REGISTERED Y/ N REE CURRE� Y/N
<br /> Address License# �_ ` �
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<br /> PLUMBER COMPANY
<br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � � �
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<br /> MECHANICAL - COMpAP1Y 1
<br /> SIGNATURE REGISTERED - Y/ N FEE CURRE� Y/N I
<br /> Address Ucense# �_ �
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<br /> OTHER COMPANY II
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N
<br /> Address � � Llcense# � �
<br /> RESILIENTIAt; Attaeh{2),Ptof P#ahs;(2}sets af:BuElding"Plans;{1)ssf of Energy�Farrns;R-0=W Permit far new constntcUon,
<br /> Minimum;ten:(.1.0)woricing;days aftec.submittal date: Required onsite,Constiuc8on Plans,SMrtnwater Plans w/Spt Fence installed,
<br /> Sanitary Facilitles,&.1.dumpster Stte Work�Permit for subdtvistonsllarge pro�eots
<br /> C8NlMERCIAI. Attach{3j camplete sets of Bulidirig Plaris plus a Life Safety Page;(1}set of Energy Forms.R-O-W Permit#or new canshuction.
<br /> Minimum ten(10)worldng days after submittal date. Required onsite,ConstrucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliBes 8+1 dumpster.$ite Work PermSt tor aH neiv projects.Ail cammetciai requlrements must meet compt3ance
<br /> SIGN PERMIT Attach'(2)�sets of Eagineered Ptans.. °
<br /> ••«"PROPERTY SURVEY required for all NEW conshuctlon.
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<br /> ( DirecNans: ' - -- .
<br /> � FIII out applicatlon completely. � • � , � .
<br /> Owner&Contractor slgn back of applicatlon,notarized ': .. '�� ', ct.,, ' r ,, , __; :s`°
<br /> If over S2S00,a Notice of Commencement Is�required.: (NC upgrades'-over 57500) '. " ' � ,
<br /> '" Agent(for the contractor)o�Powe�of Attomay(tor the owner)wauld be someone with notarized letter from owner autho�izing same
<br /> DVER THE COUNTER PERMi'i'TIF1G (�ront of Application OnIY) ._ . , '�``•": ` `"`�` `��.`�.``y :.,,,.�.,'� `
<br /> Reroofs if shingles Sewers �Service Upgrades,�AJG_;,:. �Fences•{Piaf/Survey/Footage) `'�' � �
<br /> -«_._ .._ , � , :i,,= �
<br /> Drlveways-Not over Counter If on:pubiic'roaduvays:.need`s�ROW., "�'� a; , ; '"_„ ;
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<br /> � . ., ,...,_...,r . .=A .. .: , ..,..-�t� . � - w..... ._.... . , ...,.
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