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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> .
<br /> a « 8uilding Department
<br /> Date Recelved Phone-Contacf for Permittin —
<br /> Owner's Name �AG��� ` ( c�,.v�e ��c.�� Owner Phone Number
<br /> Owner's Address D Owner Phone Number
<br /> Fee Slmple Titleholder Name Owner Phone Number-
<br /> Fse Simple Titleholder Address
<br /> JOB ADDRESS 6 2 o q � L r N N�T LOT# �
<br /> sue�ivisio� PARCEL ID# � O Z. - 26 - Z l -- 0 0 Z a- 0 03Qd , po��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH " �
<br /> INSTALL 8 REPAIR -
<br /> PROPOSED,USE Q SFR- Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK ` Q FR�4ME Q STEEL Q
<br /> DESCRIPTION OF WORK �'"�".S �(
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> QBUILDING $ VALUATION�OF TOTAL CONSTRUCTION
<br /> �LECTRICAL $� , AMP SERVICE PROGRESS ENERGY Q W.R.E.C.
<br /> ao . �ov
<br /> OPLUMBING $
<br /> QMECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING Q SRECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N
<br /> Address Lfcense#
<br /> ELECTRICIAN COMPANY ��'.r �L��7� �(� �LC
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addresa l License# �-- C���2
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� ' Y/N
<br /> Address License# '
<br /> MECH/iNICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Address License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N.
<br /> Address License#
<br /> RESIDENTIAL Attach(2)FlotPlans;(2)sets�of:Bullding Plans;(1)set of Energy°Forms;R-0=W Pertnitfor new construction, "
<br /> Minimum tem(10)workingidays:after,submittal date: Required onsite,Constniction Plans;3tormwater Plans w/Silt Fence installed,
<br /> _ ' Sanitary EacilfUes&1,.dumpster,Site Work=P.ermit for su6divisionsAarge pro)ects - �
<br /> � COMMERCIAL� AtNach(3)complete sets of Building�Plans plus a Life Safety Page;(1)�set of Energy Fortns:R=0 W-Peimit fo�new aonstriiotion:'" .�-'
<br /> _----Minimum ten(10)working days after submittat date. Requtred onsite,Constructlon Plans,Stormwater Plans wl Silt Fence installed, � �\
<br /> � " Sanitary Facilitles&1 dumpster.Site Work Fertnit for all new projects.All commercial requlrements must meet compNance
<br /> SIGN PERMIT Attach(2)sets of Eng(neered�Plans._�.
<br /> ""PROPERTY SURVEY required for all NEW construction.
<br /> Directlons: � � , ,-
<br /> Fill out applicatlon completely. ' i - �. �,
<br /> Owner&Contractor sign back of applicatlon,notarized � � � �' � `��y � ;
<br /> If over�2500,a Notice of Commencement is required. (AIC�upgrades`over,�57500) _ .�_., �`-;;�, � `; j�J� ..
<br /> .,�;�..
<br /> " /�qent(for ttie contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same �
<br /> DVER THE COUNTER PERMITIING �� (Front of Application;Only) -� . LL �` `- -"�= �•� � °':`•-...� v � .� _ . ,
<br /> Reroofs if shingles Sewers Service:Upgrades,ALC; . .Fences;(PIoUSurvey/Footage) . • • -� ���_� ��
<br /> .. , . ,.: . ��. � .� ..,.,�!; ,
<br /> Drlveways-Not over Counter if on public roadways..needs ROW � � f , " � � ' '""`� � -_-
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