|
813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Departrnent
<br /> Date Received'
<br /> Phone�Contact=for'Permtttln •-� -
<br /> Owner'�Name dC t�G" �� Owner Phone Number
<br /> Owner's Address — 7 T� � OwnerPhone Number
<br /> Fee Simple Tltleholder.Name Owner Phone Number ,
<br /> 3,;r, �
<br /> Fee 3imple Titleholder Address '� -
<br /> JOB ADDRESS � / '� e � � LOT# �
<br /> SUBDIVISION PARCEL ID# � �� - I t�0 I� 4 0 /C�
<br /> (OBTAINEDFROMPROPERTYTAXNOTICE�, --
<br /> WORK PROPOSED - '� NEW CONSTR ADD/ALT Q SIGN Q � Q DEMOGSH -
<br /> INSTAtL , BI, REPAIR
<br /> PROPOSED-USE Q SFR -Q COMM Q OTHER-
<br /> TYPE OF CONSTRUCTION� Q BLOCK " Q FRi4ME �Q STEEL Q
<br /> DE3CRIPTION OF WORK � S� �!
<br /> BUILDING�SIZE � SQ FOOTAGE� � � HEIGHT_ ;
<br /> � QBUILDING $ -<.,�•.:�;..:... . ,n . .. _ '"
<br /> • OO• VALUATION`�OF TOTAL CONS7RUCTION
<br /> QELECTRICAL $ AMP SERVICE - Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ - ' ��
<br /> Q MECHANICAL $ ; -VALUATION OF MECHANICAL INS7'ALLATION -(;� ( �
<br /> ' l�
<br /> QGAS �ROOFING :Q SPECIALT,Y Q OTHER _ ,n ��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES_ NO I �V
<br /> BUILDER � COMPANY �_ _
<br /> SIGNATURE � REGISTERED Y/ N Fee cuw�n Y./N. . .
<br /> �►ddress •V ,� (�O �t e� ^� License#+
<br /> ELECTRICIAPI COMPANY ' '
<br /> SIGNATURE y REGISTERED Y/ N FEE CURRE� Y/N '
<br /> Address - Lfcedse.#,
<br /> PLUMBElt , COMP.ANY� --�
<br /> SIGNATURE „ REGISTERED Y/::,N � �>•�FEE CURRE� Y/N: '
<br /> Address Ucense# :. � �
<br /> MECHI4NICAL . ,.COMPANY � �
<br /> SIGNATURE ` REGISTERED. -Y::/�N . ,FEE CURRE� Y/N ,
<br /> Address '. , ' . ' License# �
<br /> OTHER � COMPANY �
<br /> SIGN�►TURE � ' � ' REGISTERED Y/�N-:. � FEE CURRE� ;,. Y�%N� ,
<br /> l�ddress I - . � -.,`�� ` - - ` ' � Gcen'se# �
<br /> ,,.z ..,,..�.,,�,. -� ., -, <,;_..... . ��,:,. . ._, :� ,;�j.: •�s::�.,: :..,,.:< <>:r.',. ,
<br /> RESIDENTIAI;.- ��Attach,(2).:Plot;.P..lans;;(2).sets.of�Bullding'Rlans;(1)'setiof�EnergyForms;�R-O=W:Permlffor�ew;:construction, ,
<br /> �::,Minlmumr,ten:µ(�10);,working;d'a.ys�;aftec;submlttal;date:�Required�onsite,:ConstnictiomPlans;}Sto`rmwater Plans w/Silt Fence installed,
<br /> ' �Sanitary�Facilitles;&,1_;dumpster.Slte�,Work{Per,mitfor""subdivisions/lerge;'pr�ojects: ';=.�:`_;-:"�'=; '.;' �
<br /> COMMERCIAL Attach(3)`c;omplete 5ets of Building Plans�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days'af4er submittai date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanihary Facilitlas&1 dumpster.Site Work Permit for all`new'prcjects.All commercial requirements must meet compllance
<br /> SIGN PERMIT AttacFi(2)'sets of`Engirieered�Plans:i�;�,�.���,�b _ ... �_ : . �
<br /> ""PROPERTY SURVEY reguired,for.all,NE1l.V_wnstcuction.,.. _ ' ,
<br /> Directlons: ,-_. . ` . . _ ,
<br /> Fill out applicatlon completely. -
<br /> Owner 8�Contractor sign back-of appltcatlon,notarized
<br /> If over�2500,a Notice_of:Commencement i�requlred. (A!C upg�ades over 57500)
<br /> .. �.�.<;,t�;,.r_;...,:
<br /> Agent(for the�contractor)or'Power of Attortiey�(for tti'e,owner)would be someone with notarized letter from owner authorizing same
<br /> O.VER THE COUNTER:.P.ERMITTING. �-- {Eront-of:Application Only)� - ' ' �� � ; "
<br /> Reroofs if shingles Sewers Service Upgrades NC Fen,ces(PIot/Survey/Footage)
<br /> ��' , , _
<br /> Drlvewrays-Not over Gounter if on public roadv+rays.'.need's ROW� -.
<br />
|