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813-780-0020 City af Zephyrhills Permit Application Fax 813-780-0021
<br /> Build�ng Department
<br /> Date Received j� f ��j Phane�Cantact for Psrmtttin �� 1 � — �d �3��
<br /> I Owner's Name Owner Phone Number �fJ� G --
<br /> Owner's Address � �w �� ,,.- Owner Phone Number r �
<br /> Fee Slmple Tltlehold�r Name ' Owner Phone Nuenber �— �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � LOT# C�
<br /> SUBDNISiON PARCEL ID#
<br /> (OBTAINEQ FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEw CONS'TR ADDJALT ��' SIGN Q Q DEMOLISH
<br /> � INSTALL REPAIR
<br /> PROP08ED USE Q SFR Q COMM [� OTHEi2
<br /> TYPE OF CONSTRUGI'ION Q LOCK " Q FRAME � BTEE� Q
<br /> pE3CRIPTION OF WORK �' � q � rt '� � l�
<br /> BtlILD1NG S1ZE � I .SQ FOOTAGE HEIGHT C`�
<br /> ���i�'����' (" w � VALUA710N"<)F�TOTA�CON87RUCTlON
<br /> ��
<br />' QE�ECTRiCAI. � � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C.
<br />, [�P�UMBING � ��1��
<br /> ' � �(
<br /> �MECHANIGAI $ D VALUATION CtF MECHANtGAI.INSTA�LATION
<br /> i
<br /> ' QGAS Q ROOFING Q SPECIAl.TY � OTHER "
<br /> � FINISHED FLOOR ELEVATIONS r�� FLOOD ZONE AREA QYES NO
<br /> L
<br /> BUI�DER COMPANY
<br /> ' SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> I,
<br /> i Address Cicense# r� �
<br /> liEIECTRICIAN COMPANY
<br /> � SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> I
<br /> �, Addrsss License# �— �
<br /> I PLUMBER COMPANY
<br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address License# �� �
<br /> MECHAP111CAL ...., COMPANY
<br /> SIGNATURE +�.,,�r� REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> � Address Y� License# �� �_G��''� (��� �
<br /> OTFiER COMPANY
<br /> SIGNA7URE REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Address Cicense# �i �
<br /> , RESIDEN'ilAL Attach(2):Plot�Plans;(2}sets of 8tiilding Plans;{1)set of Energ}+�Forms;.R-O-W Permit far'new constsuc6on,
<br /> , Minimum,ten;(1.0}.working;tlays after..submittal date. Required onsite,ConsfiicBan Pla�s,Stortnwater Plans w/Silt Fence fnstalled,
<br /> , Sanitary Facflltles&,1.dumpster;Site'Work�i?ertnitfor subdivislons/large'projects
<br /> COMMERCtAL Attach{3}complete sets of Builclirig P}ans ptus a l.ife Safety Page;{1}set of Energy Forms.R-0 W Permtt for new cansUvc°tlon.
<br /> Minlmum ten(10)warking days after submfttal date. Required onsite,ConsUucUon Plans,Stortnwater Plans wl 8ilt Fence installed,
<br /> Sanitary Facili8es&1 dumpster.Site.Work Pertn(t for all new projeats.All commercial requlrements must meet compltance
<br /> SIGN PERMIT Attacli{2}"sets af Ecigineered,F?lans.., � .
<br /> ""PROPERTY SURVEY required for all NEW canstrucUon.
<br /> Dlrections: r
<br /> Ffll out appNcation completely.
<br /> Owner&Contractor sign back of applfcaflon,notadxed
<br /> i If over�2500,a Notice of Cammencement Is requ9fed. (A/C upgrades over�7500}
<br /> �� '" Agent(for the contractor)'or Power of Attamey(fqr the awne�)wauld be someone with notarized letter irom'owner autho�izing.same_ , �
<br /> i .. - „ .�-. :_ _>. ..... ........:... .�,: :t - -1 �;. .. --
<br /> I C3VER TNE COUNTER RERM1771t1G (Front of^ApPlira�on.On.iyj.;:;<;:.: ' , ,i�, , . , _ , � ,.
<br /> , . ;�:
<br /> Reroofs if shingles Sewers r: Ser,vlcafUpgradc�s.AlC•G;,� -Fences,(F'kaUSurvey/Foo#age) ,;- • � - `
<br /> ( ," [J���� -�wi(i`.'-_'�J .� ^_,': ' _ �`. , a. � a .._ ,.� ��]1t ... - _ T.i�
<br /> ..� ,
<br /> Driveways-Nat over Coun#er if on,public.roadways::needs•ROW;;,f•�;`�' ' � -� --- , ,, .' �`�r
<br /> ,...x .-..__.. .._ • <... ,. .. ._..�„�..�-_.-.� . . ,.� ,--_
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