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s��-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . Bullding Departrnent
<br /> Date Received 3 ��'. :
<br /> ' Phone�Contac4`tor`Permlttln - � Z '._.-.�i.77 —- c�T3
<br /> Owner's Name � L � Owner Phone Number'
<br /> �/' A�
<br /> Owner's Address �b � �_ �eOwnerPhone Number
<br /> � �a�)
<br /> Fee Simple Titleholder Name Owner Phone Number •
<br /> Fee Simple Titleholder Address `° - - ✓
<br /> JOB ADDRESS S LOT# �
<br /> SUBDIVISION PARCEL ID# ^ ^- � -� G 0 �
<br /> - , (OBTAINED FROM PROPERTY TAX NOTICE).
<br /> WORK PROPOSED '� NEW CONSTR ADD/ALT Q SIGN [� Q DEMOLISH -
<br /> B INSTAtL � B, REPAIR ,
<br /> PROPOSED USE Q SFR. Q COMM Q OTHER �
<br /> TYPE OF CONSTRUCTION' Q, BLOCK '` .Q FRAME - Q STEEL Q �
<br /> DESCRIPTION OF WORK ^ r
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT . ` 4�� ��/S
<br /> QBUILDING S VALUATION�bF TOl'AL CONSTRUCTION
<br />, � (7 •
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C.
<br /> OPLUMBING $ 7� ZZ'--
<br /> _� � .
<br /> �' �
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTAL4.ATION � �W�'_"I_ ,,
<br /> «LIV�v
<br /> , �,v i.��
<br /> Q�S Q ROOFING ,-Q SPECIALN Q OTHER � � G�
<br /> , L��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES: NO �,�,
<br /> BUILDER �S l� COMPANY , � �I �}., / .e ,
<br /> SIGNATUItE REGISTERED Y/ FEE CURRE� ,Y./ � I
<br /> Addre s v� fis �,� � �l� License# C�
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE �' REGISTERED Y/ N FEE CUfiREA Y/N
<br /> Address - I:Icense#
<br /> PLUMBER COMPANY� �
<br /> SIGNATURE REGISTERED Y/ N • FEE CURRE� Y/N'
<br /> Addre�s License#
<br /> MECHANICAL � COMPANY
<br /> SIGNATURE ' BEGISTERED Y:/ N FEE CURRE� Y/•N�.
<br /> Address� �� License# �
<br /> OTHER - � . COMPANY � � '
<br /> i SI�3NATURE ' � ` ' ' • � REGISTERED Y/�N .• F.EE CURRE� , Y:/�N .
<br /> - �
<br /> Addres� ;��t� - "- ' _ I:icense#
<br /> ,.. . _ . , .: � .. _... . � . ,�; .,:�,.. :'';:<-.., z<':�� .
<br /> RESIDENTIAL�. '�Attach.(2),.Plot;°Plans;;.(2)setsof:Buiiding�.Rlans;(ljsefofEnergy>Fonns;�R-O=VVPermitfornew;:donstruction,
<br /> t..,_.i,., _
<br /> ;: �Minimum;.ten;(10);working;daysYafter�'s`utimlttal:dafe:�:Requl�ed onslte;�Cons'tnicBori�Plans:SforrnwateF'Plans w/Silt Fence installed,
<br /> , "SaNtary Facilitl,es.v&;�1w>,dumpster.Site�Woricti,P,ermit.for'sulidiyisions/large?projects� :>.;;.,}.3`� ,::.;. : .. ,
<br /> COMMERCIAL Attach(3)°coinplete"sets'of Bullding`Plans'plus a Life Safety Page;�(1)set of Energy Forms.R-0-W Permit for new construcUon.
<br /> Minimum ten(10)working days after submittal date. Requtred onsite,Constructlon Pians,Stormwater Plans w/Sllt Fence inshalled,
<br /> Sanitary Facilitles 8 1 dumpster:Si4e Work Permit for ali'new'project's.All commerciai.requirements must meet compllance
<br /> SIGN PERMIT AttacFi(2)'set"s�of Eriginee`ed;Plans.i,:;,:�^�r.:- .-=••� ;,. . -
<br /> ""PROPERTY SUR1[EY reguired for.all NEW cons,tr,uction..
<br /> Directlons: � . � -� _ -
<br /> Fill out applicaUon completely.
<br /> Ownar&Contractor sign back of applicatlon,notarized
<br /> If'over 52500,a Notice of Commencement ia required. (A!C upgrades over 57500) .
<br /> -,'...;.^i'f'-r"�: '-
<br /> " Agent(for the contractor)'o�:Power of Atfomey(fo��tlie owner)would be someone with notarized letter from owner authorizing same
<br />'� DVER THE COUNTER.P.ERMIT'11NG - {Front:ofiApplicafion�Only) - � -
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> I Drlveways-Not over Counter if on public roadways.:needs ROW ` �
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