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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Bullding Department .
<br /> � � - -
<br /> Date Recelved �,�'�,�� . Phone�Contact for:Parmlttln - ,� d"
<br /> Owner's Name �1��� Owner Phone Num e -
<br /> Owner's Address � LC �`� Owner Phone Number
<br /> Fee Slmple Tltleholder Name Owrier Phone Number
<br /> Fee Simple Titleholder Address -
<br /> JOB ADDRESS U I c� ` l '� ✓�� 7 LOT# �
<br /> SUBDIVISION ��! a�,�n �r�1�/` OL`„1�S PARCELID# �V �,�0 � � � b �d� �' �d
<br /> - , (OBTAINED FROM PROPERTY-TAX NOTiCE)
<br /> WORK PROPOSED ;_NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR �
<br /> PROPOSED:USE � Q- SFR Q COMM � OTHER ,,,/
<br /> TYPE OF CONSTRUCTION � �' '' BLOCK �' 'Q FRAME Q STEEL Q
<br /> DE3CRIPTION OF WORK P� {Eil i0'�-1 � � (p,IYI n/ /`[7l7�� C a�X o�
<br /> �
<br /> BUILDING'SIZE' � � SQ�FOOTAGE �SS . � HEIGHT`
<br /> QBUILDING $ - �
<br /> C� ��,p(� VALUATION=OF�TOTAL CONS7RUCTION
<br /> QELECTRICAL , $ �AMP SERVICE Q PROfqF�E{��S NERGY Q W.R.E.C.S ���
<br /> � I � � V �
<br /> OPLUMBING $ ' '
<br /> QMECHANICAL $ " VACUATION OF MECHANICAL INSTALLATION � �"'����`` . /
<br /> �� �,,�,�al�
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER G���
<br /> �
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � ��,j� ���
<br /> '�� �
<br /> _ 1/ �
<br /> BUILDER '~' �� COMPANY � R �jW�-, �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � N � � Cicense# (? �,� �ob�} �
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<br /> ELECTRICIAN; f „ I„ �:'COMPANY ' "�l U'�j' Gr/1�5 ,�(`eG �C�
<br /> SIGNATURE �SL REGISTERED Y/ N FEE CURRE�'` •Y/N '
<br /> nda�.� 7l ) � ��w� .. _ .. Gr'��
<br /> � ucense:# � G DD
<br /> PLUMBER COMP.ANY - ,. �
<br /> SIGNATURE' ' . . REGISTERED Y./.N- _FEE�CURREA Y�/N
<br /> Address �� , ' License.,# ;
<br /> MECHANICAI: ' . � �C.OMP..I4N1f _
<br /> S1�3NATURE � ' ' � QEGISTERED . , Y./ N FEE CURRE� Y/�N' •
<br /> Address" - � ` - ' � License#
<br /> OTHER � , , . , ,y.„ ., , ,
<br /> ;COMPANY
<br /> SIGNATURE - - � � • � ` ' �REGISTERED Y/ N... FEE CURRE� Y/.N
<br /> � , -. . . - . . -
<br /> Addre�s- '_ ' . �.�� , . > , - . - • ' Ucen"se#• �
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<br /> RESIDENTIAL'r a •AttacFi'(2),Plot�.P,lans;,(2)'sefslof_Bullding`Plaris;'(1)set'of�Eriergy�Fortns;�R=0-W Permlt for new construction,
<br /> = ; ;Minimum:ten�(1.0);working;days after subriiiEtal`date.��:Requireil onsitie,�Constnictlon Plans';Stormwater Plans w%Silt Fence installed,
<br /> ' ° �r Sanitary Facilides;&=1.�,dumpste_r,-Site Work�Permitfor subdiVisions/large.projects ,.__..•::: . `
<br /> COMMERCIAL Attach(3)oomplete�sets of B'uilding Plans plus a Life Sefety Page;(1)set of Energy Forms.R-O-W Permit for neui construcUon. -
<br /> , Minfmum ten(10)working days after submittal date. Required ons(te,ConstrucUon Plans,Stortnwater Plans wl Silt Fence inslalled,
<br /> Sanita'ry Facflitles 8 1 dumpster.Site Work Permit for all new:proJects.All commercial requlrements_must meet compliance
<br /> SIGN PERMIT Attacfi"(2)sets ofEngiReered:Plans.: � •- ` �. - �
<br /> ` "'•PROPERTY SURVEY reguired for all NEW construction..�
<br /> Directlons: � . - �
<br /> FIII out applicaUon completely.
<br /> Owner 8 Contractor sign back of applfca8on,notarized
<br /> If over 52500,a Notice of Commencement Is requlred. (A!C upgrades over ST500) � '
<br /> '" Agent(for the contrdctor)or"Power of Attome'y�(fo�tFie owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITTING -: •(Front of-Applicatlon Only)-�- �• ' � ` �
<br /> Reroofs if shingles Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways..'needs ROW` �
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