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<br /> 813-750-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Bullding Qepattment
<br /> . .; .
<br /> Date Received Phone Coritact for Permittin
<br /> �Owner's Name i' Owner Pbone Number
<br /> �wner's Address ., � OwnerPhone Number � �
<br /> Fee Simple Titleholder Name Owner Phone Number �— �
<br /> ,�{ �
<br /> ��
<br /> Fee Slmple Tltleholder Address
<br /> ,
<br /> ;,�OB ADDRESS C/ ' , / /S" � �:�� LOT# ���
<br /> SUBDIVISiON � � PARCEL tD# � �
<br /> (OBTAINED FROM PROpERTYTAX NOTICE).
<br /> WORK PE20POS5D , e '• NEW CONSTR��1 ADDIAL.T [� SIGN Q � Q pEMOt,ISH -
<br /> IMVSTALL "Q REPAIR
<br /> PROPOSED USf SFR �Q CQMM � OTHER
<br /> TYPE OF CQNSTRUGTION s � BLOCK " � FRAME � STEEL. Q,
<br /> DfSCRiPTIQN OF WOitK � "�
<br /> BUIl.p1EtG SIZE � SQ FOOTAGE�� HEIG1iT����
<br /> . QBl}I�D1NG �..�� �,:...�,�....� ,�.-. - � �
<br /> VALUATIOM1I'�3F TOTAL CONSTRUCTION
<br /> QEI.ECTRICAC � � AMP SERVICE � Q PFtOGRESS ENERGY Q W.R.E.C.
<br /> QPRUMBING �.11 � ' � �`
<br /> /l
<br /> ���MECNANlCAL � VAIt}ATION C3F MECHRNICAL IiVSTALlAT10iV ��
<br /> M �
<br /> �
<br /> OGAS Q ROOFlNG� Q SPECIALTY �� OTHER
<br /> FINISHED FLOOR ELEVATIQNS ��� FLOOD 20NE AREA QYES NO
<br /> BUII.pER COMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURREK Y./,N
<br /> Address License# �— �
<br /> �.
<br /> E�EG7RICIAN COMPANY
<br /> SIGNI�TURE � REC�157EREp Y/ N FEE CUFtREP Y/N
<br /> Address � . �Ltcense# I �
<br /> ,
<br /> PLt1M8ER COIVIPANY , ,
<br /> �� SIGNATURE REGIBTERED , Y/-N FEE CURRE� Y/N
<br /> Addre8S -� � - , nS6# ,
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<br /> MECl�1AN1C GOMFANY e``� C��
<br /> SIGNAT E � � REGISTERED . Y•/ N ,,.FEE CURRE� Y/-N .,
<br /> Address� . . . ,: . - --
<br /> - � _ Licen'se# ��������
<br /> OTHER COMPANY - ,
<br /> SIGNATURE ' � REGISTE�D � Y/ N.. ` .Fee cuR�n , YJ•N .
<br /> Addrass , - _�- _ . - � . ' License# � �
<br /> ,�..,. -�.,-.,� t ...,. . :�- � ,}:.,. � : .� ..;�.s,�..i,: ,�•;,. ,� .,t..t ; .
<br /> I RESlD�NTtAL -Attacli.{2j!?Idt:P.,lans;.(2)ysets:of'Bultdtng;:Riaris;{i)sef af�Erieigy�Farrris;R-O=W�Ferii�lf.fcir nevi%,construc�on,
<br /> : ,.,.,
<br /> Minimum��ten:(1.0)woricing�days.afte�,.submlttal:datec�Requlred onslte,-C'onstruction�Plans;�Stormwate�`Plans w/Silt Fence installed,
<br /> ` �Sanitary Fecill8es.&�1.idumpste_r;-Site:Work;Rermit for`sutidivfslCnsllarge'prqjegts° .� �w��'-'.°'. ' `
<br /> 1 GOMMERCtAt. Attach{3}xaiiaplete'se#s oF Bulldirig`Plans plus a t.[fe 8afety Page;{1)set o�Energy Forms.R 0=W Permit for new constnscticn.
<br /> � Minimum ten(10)workfng days�after submittal date. Required onstte,Constructian Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FadliBes&1 dumpster.Site Work Partnit ior ali`new'projects.All commerciaf requirements mast meet comp8ance
<br /> SI�N PERMIT Attacti{2}"sets af'�riglneered=Plans:-,:f�;��� ,.� F -. ., � .. , ,
<br /> """PROPERTY SUR1%EY reguirecl,for aII.,NE1N constnictlan. .
<br /> A3rectlons: , .. , . ,
<br /> FIII out applicatlon completely.
<br /> Ownar 8 Contractar slgn back-of applicaUoa,notarized
<br /> tf aver S28d4,�Notice af Commencement is required. {AtC upgrades over i7so0)
<br /> .. �.•:,•',:��F,:;;�,.: ._ .�. -
<br /> Agent(for Nie contracto�)`4r:Power.of Attomey�(fa��tFie owner)would,be someone with notarized letter from owner authorizing same
<br /> OVER'TH�COUNTER�PERMI?fTtNG- -- {Front.of�Applicat}on anly)<- ` �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences�(PlodSurvey/Foatage)
<br /> - � „- ,: • ,
<br /> Drlverways-Not over Caunter if an publEc roadways..needs ROW- - -
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