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813-780-0020 City af Zephyrhills Permit Application Fax-813-780-p021
<br /> Building Department
<br /> Date'Rscalvsd --' .� —'" '' • P1�ons=Contact:far Permitttn =-_ ; - � �
<br /> ' W�\.?-� ' ' ' -
<br /> Owner's Name \��0� N e � Owner Pteone Number
<br /> 1 �. .
<br /> Qwner'a Address �1 � Owner Phone Number ' �
<br /> Fee Simple Tlkleholder Name � � Owner Phane Number � �
<br /> s,{ '�`—
<br /> Fee Simple Tltleholder Addres� "
<br /> JOB AClDRESS �� �'�� �� d'��� \ LOT# ��
<br />, SUBDIVISION �� � ' PARCEL ID# � �' �� � ��� 1��1 � O r ����� "�
<br /> (pBTA1NED FROM'PROPERTK TAX NQTICE)�
<br /> WORK AROPOSED '�NEW CONSTR' ADD/ALT Q $IGN� Q Q DEMOLISH
<br /> e� ,INSTALL 8 REPAIR -
<br /> PROPCISED=USE Q SFR �. COMM C� QTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK `` Q FRAME [„� STEEL Q
<br /> DESCRIPTION OF WQRK c' �e-'r C10 ��. �� ��'����
<br /> BUILDING SiZE -�� � SQ.FOOTAGE��. HEIGHT �� ���d��a.�{ ��
<br /> � � �, �
<br /> �����"d��� $�'" � VALUATION�O'F'�OTAL CONSTRUCTION
<br /> ,
<br />( QEIECTRICAl. . $ AMP SERVtCE 'Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUM$IN� � ,,,, „ „
<br /> QMECHAIVICAL � � 1lALUATION C?F MECHANICAC It�iSTAttATlt}N �f�/�jy�,
<br /> � � , _
<br /> O� O ����
<br /> � RQOFINt3 � ..
<br /> SFEGIALTY �� � OTNER. �,�'"I
<br /> FINISHED FLOOR ELEVATIONS Fl.00D ZONE AREA QYES NO
<br /> � �
<br /> BU[CDER COMPANl(
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURREN ' Y/N`
<br /> Address - Cicense# �� ��
<br /> ELECTRICIAN! � COMPANY - -
<br /> SIGNATURE �' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address , License•#. �_ � �
<br /> PLUMBER GOMPANY
<br /> SIGNATURE ' � ,REciS.TeReo . Y/-N. FEE Cu�ten. Y/N
<br /> ��r�� Ucanse#�� �
<br /> MECHANICAl. COMPJtt�tY<. �
<br /> SIGNA7URE � r. �cisTEReD Y,I..N FeE Cu�n .Y/N
<br /> , Address. , � . � , , . License# �
<br /> _�___ �� �� . � ` t� �} ` ,�'
<br /> O'fHER - `��O ��)�-�'v-`'-' '� COMPANY. ` JG� ���c��cv�C�t�-� `�-E�o��t
<br /> SIGNA7URE� � �����-`� REGISTERED Y/ N< FEE CURRE� Y/N
<br /> Addras� C3�t�; `\�) `�`�,,•..�-����ei �L � .� License# i �C.._�O�'-1 I`�.�� �
<br /> T
<br /> l2ESlt}Ef�tT1A1:, �';Attach 2;PIot.Plans�.2;setsaof:Biiilclln �Plans;-{1j'setofEne� Fomis:'Ft=O-UStFeiriiitfor'nerivc;4nstiucHon, . � . �
<br /> ( } . `{ } 9 .. r9Y' -
<br /> : �Minimum�.tent(,1,0);,w,o.,rking;days,;aiter;.subrrilttal�date:::Required,onslfe;Gon`sUucd'oir-Plans;Stormfwater Plans w/Sqt Fence installed,
<br /> �Sanita�jr Facllitles�&�,1��dumpste_r,Slte�:WorksPermik for subd[vislons/large;proJects � "' �
<br /> COMMERCIAl. Attach{3}aomplate sets'of Building'Pians°qlus a�:ife Safe#y Page;(1)set of Enargy Fonns.R-O-W Permit for new constsvction.
<br /> � Mfnimum ten(10)waricing days'afker submiltal date. Required onslte,ConstrucUan Plans,Stormwater Plans w/SUt Fence installed,
<br /> Sanitary Facllides&1 dumpster.Site Work Permlt tar alt new�projeGts:A!i commerciaf requtremenLs must meei compt}ance
<br /> SIGN P�Rl�17 Attacti{2)sets cf`Eiiglneered:Aians:a;��,������,`;---� ,�= ,�� -� „ � � _
<br /> "•""PROPERTY SURVEY required for all WEW canshuction.,.
<br /> Directions: ; ' . , . -
<br /> Fill out applicatlon completely.
<br /> O�wner&Cantractor sign back of applicattan,noiarized
<br /> tf over$250d,a Notics af Commencement is requlred. (AlC upgrades over�7�00j
<br /> .. .� .,�:,:,,:.�.... . _ _- . ... .... .. . ......�_..� .
<br /> Agant(for the contracton)or Power'of Atto"rney(for tt�e ownerJ would.be someone with notarized letter ftom owner authadzing same
<br /> OVER THE COUNTER PERMITiiNG..-..�.-.(Front-of•ApPlica�an.Only) ; ' �
<br /> Reroofs if shtngles Sewers Service Upgrades NC Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on public roadways..need"s ROW` �
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