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t313-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department �
<br /> Date Recelved -'Z-�� Phone.Contact for Perm(ttin -
<br /> Owner'a Name �oG���-� p Owner Phone Number �� `-t-��.P `-t�-�
<br /> Owner's Address 2✓'�-1��5 <e,v�. �� Owner Phone Number �
<br /> Fee Simple Titleholder Name ��� ��S `a Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION PARCEL'ID#
<br /> (OBTAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED , NEW CONSTR ADD/ALT Q SIGN' Q Q _DEMOLISH ��
<br /> B INSTALL 8 REPAIR �f,_.�-- ' ��•�,
<br /> PROPOSED USE Q SFR Q COMM Q OTHER ' +
<br /> TYPE OF CONSTRUCTION Q BLOCK * Q FRAME Q STEE� Q t _
<br /> I ` _\["�
<br /> Y
<br /> DESCRIPTION OF WORK ��C�0.�� c7� �� ��� /�
<br /> � �� � .' r.
<br /> BUILDING SIZE SQ FOOTAGE�, HF�I��'P' '�AI-�LfJ ����� ��� rJ�� �/
<br /> '� � ��Y,• ;`•: �•
<br /> BUILDING $ � � VALUATION OF TOTAL CONSTRCLC?�OI��,`L y} _� !Y_
<br /> �,_. - ---- `
<br /> ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q _ W.R,E.C.
<br /> i� % �
<br /> QPLUMBING $ �(,��0� V� _-G� '���
<br /> x� ,�����.��' �����`�� �-���.W�,-�
<br /> t���.°�� _ .. ��;�_
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALL��(�� �� y�
<br /> ��.�.����`�1�� 'k"
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER � �� i � COMPANY �t-�5�`�-� U �v' t�
<br /> SIGNATU REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address L`Icense#
<br /> ELECTRICIAN y COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addresa License#
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y:/ N FEE CURRE� Y fN
<br /> Addres� License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� , Y/N
<br /> Address � License#
<br /> RESIDENTIAL: Attach(2)Plot P.lans;(2)sets of:Building�'Plans;(1)set of Energy�Form§;R-O-W Permit for new construction,
<br /> _ Minimum..ten(10),worktng:days,aker._submittal date: Required onsite,Construction Plans;Stormwater Plans w/Sllt Fence installed,
<br /> Sanitary FaciliUes 8.1.,dumpster SIte,WorlcRertnit for subdivislonsAarge proJects
<br /> COMMERCIAL Attach(3)complete sefs of Building Plans plus a Ufe Safety Pege;(1)set of Energy Forms.R-O-W Permit for new construcUon.
<br /> Minimum ten(10)working days after submittal date. Re,quired onsite,ConstrucUon Pians,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Permlt for all new projects.All commercial requirements must meet compllance
<br /> SIGN PERMIT Attach(2)sets of Engineered-Fians..,, ��
<br /> •'•'PROPERTY SURbEY required for all NEW construction.
<br /> Directlons: -
<br /> Ffll out applicatlon completely.
<br /> Owner 8 Contractor sign back of applfcaUon,notarized _ --
<br /> If ovar a2500,a Notice of Commencement Is-required. (AlC upgrades over E7500) �
<br /> " Agent(for ttie contreotor)or Power of'Attomey(fo�the owner)would be someane with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITTING --.,.t:(Front of�Application�Only)=-�-,-� .=�•� ' ' ,', ` ' _, - � ;� -
<br /> Reroofs If shin les Sewers �,Service U rades'•AIC .'� �•Fances"•PIoUSurve /Faota e ` ` ��� -= � '•
<br /> 9 P9 (: Y 9 ) � � ,.
<br /> ,-, :, � , -,-' , , , . , �,y' ; ;
<br /> . ;: ,�,' �_,.;�:,�,:.;. � � _ , ' ,
<br /> Driveways-Not over Counter if on pubiic roadways:needs�ROW:' ��;"�;-,• � „ ` ' ' ''ti`` __ '
<br /> .'ti..a .�...-. ,.......�..,, ....�:_ ,.-... : ...�. --., �._- -- � _ , _.. .
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