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' a��-7so-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department
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<br /> Date Received ,: " � , . .. - • ' '" "
<br /> Phone Contact�for.'•Permittin :°,��''- ' '. . —
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<br /> Owner's Name • - ' Owne�Ptione=Number,_,.
<br /> Owner's Address J / • �'"OVir'rier-Phone Number
<br /> Fee Simple Tltleholder Name � Owner Phone Number
<br /> Fee Simple Titleholder Addres� °°
<br /> JOB ADDRESS �� �� , �G'L � LOT# �
<br /> SUBDIVISION P PARCEL ID# " -
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED '^ NEW CONSTR ADD/ACT Q SIGN Q . Q DEMOLISH' -
<br /> INSTAtL 8' REPAIR
<br /> PROPOSED USE .Q SFR Q COMM Q OTHER
<br /> TYPE OF CON3TRUCTION' Q BLOCK `' Q FRAME � STEEL Q `
<br /> 'Y
<br /> DESCRIPTION OF WORK ,'_ 1�� s _ �� �,{f��� �• �
<br /> BUILDING SIZE SQ FOOTAGE C�. .HEIGHT
<br /> � QBUILDIiVG $ •,.��M-:�� �,� _..._..
<br /> , . ,VALUATION"�F TOTAL CONSI'RUCTION
<br /> �ELECTRICAL $ G� �� , AMP SERVICE •/'(�'� � PROGRESS ENERGY Q W.R.E.C.
<br /> O Y
<br /> OPLUMBING $ � ' �//�//?-�
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<br /> QMECHANICAL $ � , VALUATION OF MECHANICAL INSTALLATION
<br /> Q�S [� ROOFING Q SPECIALTY.�, OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES. NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N �E CUR�n Y./N
<br /> Address Cicense#
<br /> ELECTRICIAN � COMPANY / �(�
<br /> SIGNATURE � i/' REGISTERED N l FEE CURRE� Y/N
<br /> Address �Ox � � � _ � ,.3 �, : -.ucense# � 1G
<br /> PLUMBER Cpy�pqNy: , ,
<br /> SIGNATURE ReGiS�rtEo - Y/..N FEE Cu�� Y/N:
<br /> Address ,l:icense# - -�
<br /> MECHANICAL , COMPANY ,
<br /> SIGNATURE
<br /> REGISTERED Y./ N , FEE CURRE� Y/.N�
<br /> Address- � ' ' `
<br /> License# .
<br /> OTHER ' � COfVIPANY '
<br /> SIGNATURE, - � ° REGIS7ERED - Y/ N . " , ;FEe CUttRE� .. X:/•N..
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<br /> Addreu _ -
<br /> License'#
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<br /> J. _ ., � .. i_,.�r , �, :.�.�:�� _. �..' ' ; .,,�'" '`.:.. .i'E'�. ,-
<br /> RESIDENTIAL` 5 �Athach,(2):PIot�Pl`ans;::(2)sets:of;Building,Rlans;.(1)sefof�Energy�Forms;;R-0=W°Perrnitfor'new;construcUon,
<br /> �.Mfnimums.ten.�(1,U};yvorktng;days�after?"sutimiftal dafe.�.Requlr'ed onsite;�C'onstnicBori�Plans;-Stormwate�`Plans w/Silt Fence Installed,
<br /> ' '�Sanitary-FaGltyes,,&ri1;;dumpster,;Slte;Work;Permitfor:subtlivislons/large'proJects�-•°• `��{t�. ��,` �'a = ��
<br /> COMMERCIAL Attach(3)'oomplete sets�of Bullding Plans`plus�a Ufe Safely Page;�(1)set of Energy Forms.R-O-W Permit for new consUucUon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Santtary FaciifUas 8 1 dumpster.Site Work Permit for.all`newiprojects.All commercial requirements must meet compllance
<br /> SIGN PERMIT Attacfi(2)'sets of'Eng,i`nee�ed��Plans.z•2,..-,��:`• ---._ . ,._ . � . �. '
<br /> "'"PROPERTY SUR1%EY reguired foraIllVEW consttucUon:.:.
<br /> Directlons: . .,� ,- _ �
<br />� Ffll out applicallon completely.
<br />, Ownar&Contractor sign back.of appllcatlon,notarized
<br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over 57500)
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<br /> Agent(for the�contractor)�or:Power�of Atfomey(fo�tF�e owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITIING --�:-{Front-of-Application Only)� •• ' �' " ' �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> ,_ y-` ,I",- w,}_. _, - � - -�,- ,
<br /> Drlveways-Not over Counter iF on public roadways.:needs ROW
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