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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> " Building Departrnent ��y
<br /> !�f•�' ���
<br /> Date Received �/Z,�/�Q� , ��
<br /> � �Phone Contact for PePmittin �
<br /> Owner's Name ��� //-��'e� ��5��/U Owner Phone Number `�Z�"Z`�3'"�-�`f.3
<br /> Owner's Address (Gf��Z �e�' e��/�N� ��,P� Q�°���Si��" Owner Phone Number
<br /> Fee Simple Titleholder Name � Owner Pfione Number
<br /> ,;,�, .
<br /> Fee Simple Titleholder Address , `�
<br /> JOB ADDRESS �0�� J�� J�I° �e/��i i�i���5� �� LOT# �
<br /> SUBDIVISION PARCEL ID# � �
<br /> - (OBTAINED FROM PROPERT1f 3AX NOTICE)
<br /> WORK PROPOSED -^NEW CONSTR ADD/ACT Q� SIGN� Q Q DEMOLISH
<br /> - INSTALL ,8 � REPAIR - �
<br /> PROPOSED USE Q "SFR Q� COMM� Q OTHER�
<br /> TYPE OF CONSTRUCTION •• Q BLOCK " Q ' FRAME [� STEEL Q
<br /> DESCRIPTION OF WORK ,' ���e�OtJ� ��02 ���PI�G� f,���� �j y�/'GQQ�
<br /> BUILDING SIZE � ` SQ FOOTAGE�, _ ,HEIGHT,
<br /> QBUILDING $ ��c-�c .�p .VACUATION`OF'fOTAL CONSTRUGTION
<br /> QELECTRICAL $ AMP SERVICE � �Q -PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ -
<br /> �i� ��z��
<br /> QMECHANICAL $ � VALUATION OF MECHANICAL,IN3TALLATION 7T
<br /> QGAS Q ROOFING Q SP.,ECIALTY•Q, - OTHER. �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> ; -
<br /> .. � 1 U` �/
<br /> BUILDER ' COMPANY =jff�/y1L�'�C!/�c�/�
<br /> SIGNATURE REGISTERED Y/ N 'FeE CURt�� Y 6 N'
<br /> _.. `� 6 . � � � License#�
<br /> �
<br /> ELECTRICIAN: ;Fn � � COMPANY � � �'
<br /> SIGNATURE , "� ' 'l�" � ReG�s7eReo Y/ N FEE CURRE� Y'/N
<br /> �� �� , , , , � ..
<br /> Addresa License:#: •
<br /> PL�MBER �� �'� .., , COMPANY.� - - • ,
<br /> IGN�UR�jl .iiEGISTERED Y/ N F.EE CURREP Y/N
<br /> �, �GTiJ�—
<br /> Address � �License#
<br /> " 3� P,v-taDZ
<br /> MECHANICAL ' � . .._ .COMPANY
<br /> SIGNATURE ` " � '_ "�, ��is,reReo _ Y./_,N = - �e•cuwten � .Y/N .
<br /> Address` � ' License#,
<br /> OTHER " ' ,COMPANY,:
<br /> SIGNATURE` � � ' � - ' ' REGis7E�o " Y f N:... , FeE.CURt�n .Y/N
<br /> Address : ':n.�,..o-;_ ., - : , � � < , , � L'•Icense# i ,
<br /> �RESIDENTIAL:.-,''Attach(2).Plot':.Plahs;'�(2)sets�of-Buflding'Plens;�(1)'set'of Energy�Fomis;�R=O=W Perrriit'farnew constriicUon, � � ' `
<br /> • Minimum;ten;(:1,0);working day_s;afte�..submittal date:i Required.onslfe';:Constr�ctlon'Plans;Stormwater`'Pians w/Silt Fenoe installed,
<br /> Sanitary+FacilJties�&=1�dumpster,Site°Work;Permit.for sutidivislons/large proJects � '''' �- �
<br /> COMMERCIAL Attach(3)�oomplete'sets�of Building Plaris plus�a Llfe Safety Pege;(1)set of Energy Forms.R-O-W Permit for new•construction.
<br /> Minimum ten(10)working days'after submlttal date. Requlred onsite,ConsUucUon Plans,Stormwater Plans w/Silt Fence Installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permit for all new.proJects:All'commercial regulrements must meet compllance
<br /> SIGN PERMIT AttacFi(2)'s`efs of'Engfneered�P.,_lans:;ti;•r.t:._;�:-�� .�<< - � � •
<br /> ""PROPERTY SURVEY reguired for all NEW constructlon._ - -
<br /> Directfons: ;. ., ' , '
<br /> Ffll out applica8on completely.
<br /> Owner 8 Contractor sign badc of appllcatlon,notarized
<br /> If over 52500,.a Notice of Commencement is requlred. (AIC upgrades over 57500) ,
<br /> .. �-,°;w.;�r=:.�_>
<br /> Agent(for th�e contraotor)''or'Powe"r of'Attoriiey�(fo�tFie owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER;P_ERMITTING•• • (Front-of Applicaflon Only}� -•
<br /> Reroofs tf 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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