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813-780-0020 City of Zephyrhills Permit Application _ FaX-a�sasaooz�
<br /> Buflding Department
<br /> Date Recelved ' �'� 'r - ;ph e Contact:for PermltNn _ � � — �
<br /> Ownar's Name �- ner P on Number
<br /> Owner's Address � � e'� (�ner Phone Number '
<br /> Fee Simple Titleholder Name • Owner P6one Number -
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<br /> Fee Simple Titleholder Address `'
<br /> JOB ADDRESS� v v � �1-�jY � ���f � � LOT# ��
<br /> SUBDIVISION PARCEL ID# '
<br /> � . (OBTAINED FROM PROPERTY TAX N0710E)�
<br /> WORK PROPOSED `�MEW CONSTR �-" -� ADD/ALT Q SIGN" Q Q DEMOLISH
<br /> �� INSTALL ,e � REPAIR �
<br /> PROPOSED=USE SFR �� COMM' Q OTHER
<br /> TYPE OF CONSTRUCTION - BLOCK ~ Q FRAME �. STEEL Q
<br /> DESCRIPTION�OF WORK� �� e Vl. , � ���' ' ` � �
<br /> BUILDING SIZE'�� x SQ FOOTAGE�. HEIGHT . .. .
<br /> �BUILDING �, $ `�a�- � .
<br /> ;• D � . VALUATION.OF'�OTAL CONSTRUCTION'
<br /> QELECTRICAL $ AMP SERVICE� 'Q' PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING . - $ . � • C���
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<br /> QMECHANICAL $ 'VALUATION OF MECHANICAL INSTALLATION l�
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<br /> QGAS Q ROOFING �;Q SPECIALTY Q � OTHER_ � ' - `���
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES N �V.st,d� <<
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<br /> BUILDER COMPANY ��
<br /> SIGNATURH � _ � \ REGISTERED Y/ N � FEE CURREK Y/N ' '
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<br /> Address ' � License#' '
<br /> ELECTRICIAN , - • COMPANY � � - �
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres� ' - ^ . , ,. License#: a,.
<br /> PLUMBER � __ ,. , _ ; .COMPANY , - '
<br /> SIGNATURE ' ' ' -.RecisreReo Y/„N- _ : FEE cuwtEn Y/N
<br /> Address . , License# . `�,
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<br /> MECHANICAL . C.OMPANY �
<br /> SICaNATURE - � ' � REGISTERED . Y./..N FEE CURREA ,Y/N-.. M
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<br /> Addre�s'''' ` � � - License# � \
<br /> OTHER � ' - � � COMPANY ,�`• .
<br /> SIGNATURE�� "" ' � ' �� � � REGISTERED - Y/�N...: FEE CURREt� Y/N
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<br /> Address _ -...r..�s,, : , ., ` . . ' License# ' ' � O
<br /> � :-r� : ,._: ;._:_ ,�<.• �:-. ..:� . , ,. :,. � �
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<br /> ti.. -.;m....;.- ,_... . � � �.� , ...� .• _',.r. ,• = '= Vj �
<br /> �RESIDENTIAL;• ':Attach(2);P:..Iot;Plans;.(2)-sets:of;6'uflding'P..lan's;(1-)set'of EnergyFortris;�R=O-W Perrriit'forriew constiucUon,- ` �N ` �
<br /> Minlmumc,tenr(:1,0);„working;days;a(ter,_su6inNtal;d'ate:<Requlred.onsite;<Construotlon�Plans;Stortriwater'Plans w/$IIt Fence installed, � ,
<br /> �SanVtiaryrFacilitles;&�.1�dumpste_r,;Site�.Work:Permit=for su6divislons/large-pro)ects � :-�"�°• "` . .: : � "` ' ��
<br /> COMMERCIAL Attach(3);complete'sets`of Buildtng�Plans plus a Llfe Safety Page;(1)set of Energy Fortns.R-O-1N Permit for new.construction.
<br /> Minimum ten(10)worktng days'after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installe�
<br /> , Sanitary Facilidas&1 dumpste�.Site Work Permit for all new:proJects:All commereial requirements must meet compliance �
<br /> SIGN PERMIT Attacti"(2)set"s of`Engineered�;P..lans.,�:,;>�,.��.;�.:"::� •.,�� , , � • _ �- ` ` � � �
<br /> •`•'PROPERTY SURVEY reguired for aII,IVEW construcUon.. �
<br /> Directtons: ....___,�_ .. - -~ . , . - � �
<br /> Fill out applicatlon completely.
<br /> Owner 8 ContracMr sign back of applfcatlon,notarized ��
<br /> If over 52500,a Notice.of Commencement is requlred. (AIC upgrades over�7500) _ ,; � 1�
<br /> ,�::,�,s��:•�=:'�`'.
<br /> '• Agent(for the�contracMr)�or'Poinier of Attomey�(fo�;tFie,owner}would be�someone with'notarized letter from owner authodzing same � �
<br /> OYER THE COUNT.ER;P.ERMITTING�-«;-(Front'ofAppNcatlon Onlyp• � : ;�� ` - � �
<br /> Reroofs if shingies Sewers �Service'Upgrades /VC �Fences(Plot/Survey/Footage) - . � �
<br /> Driveways-Not over Counter if on'public roadways.,needs ROW -` �' . . .� � �
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