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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Bullding department
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<br /> Da#a Received � ��j '���^j r.�� � �
<br /> Phane-Contact for Permitfln �'S'13 Ga ,Y11
<br /> Owner's Name �-rrh�J'i l��1C�cf���'? ; Qwner Phone Number �/3 �53d"" '�'�('"J t "
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<br /> Owner's Address S 3Z� �Gr'� �d'���,a ,., �/ • � Owner Phone Number �- �
<br /> Fee 5lmple Titleholder Name Owner Phane Number � �
<br /> Fee Slmple Titleholder Address
<br /> JOB ADDRESS LOT# C�
<br /> SUBDIVISIOW �_ �� PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> W4RiC PROPOSED NEW CdNSTR ADDJALT [� SSGN Q Q pEMOI.ISH
<br /> INSTALL 8. REPAIR
<br /> PROP4SED•USE Q SFR � COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME [� STEEL Q
<br /> DESCRIPTION OF WORK ,/U��G/ � , ��J -,-�'�7 C� ���'�
<br /> BUILDtNG SIZE �� � SQ FOOTAGE� HEIGH7 �`�
<br /> �BUIt,DING $ -�...,�. - �
<br /> �Q� VALUATiON GIF TOTAL CONSl'RUCTION
<br /> QEIECTRtCAL � � AMP$ERtliCE Q PRQGRESS ERtERGY Q W.R.E.C.
<br /> QP�UMBtNfi., �$ � ����C��
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<br /> QMECNAHICAE. � VAlUAT10N OF MECHANICAt lNSTAIIATlON
<br /> OGf.1S � ROOFIl�tG Q SPECIALTY C� OTIiER
<br /> FINISHED FLOOR ELEVATIONS �--__� FLOOD ZONE AREA [�YE$ NO
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<br /> BUIIDER . COMPANlt
<br /> SIGNATURE REGIS7ERED Y/ FEE CURRE� Y/N
<br /> Address � �7 rGt/� 9i��� ,� h t Lfcense# � � �
<br /> ELEC'fRIC1AN COMPANY
<br /> SIGNATURE � REGIS7ERED Y/ N FEE CURRE� Y/N
<br /> Addrass License# �- �
<br /> PLtlMBER COMPANY
<br /> $IGNATURE , r, _, REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s License# � �
<br /> MECFf�4l�i1CAC. COMP.ANY
<br /> SiGNATURE REGISTERED Y,/ N FEE CURRE� Y/N
<br /> Address License# � �
<br /> OTHEE2 CONIPANY
<br /> SIGNA7URE REGISTERED Y/ N- FEE CURREA Y/N
<br /> Address License# �� ��
<br /> RESiDENTiAl. °Attach(2}Plot Plans;{2)sets�of Btiitding'Atens;{1)set of Energy Forms;R O-W Perrnit for new construetian,
<br /> Minimum,ten_(1.0)working;days after,submittal date: Requlred onslte,ConstFuction Plans;Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Faoilttles&1.dumpster,Site Woric Rermtt for subdivislonsflarge proJects
<br /> G014tMERGiA1. Attach(3}comPtete sefs of Suildltig Plans plus a l,ife Safety Page;{1)se#of E�ergy�'omts.R-Q-W Permit for new c:onsttuction.
<br /> Minimum ten(10)working days'after submittal date. Requfred onsite,Construc8on Pians,Stormwater Plans w/Silt Fence installed,
<br /> Santtary Facilitles&1.dumpster.Site Work Permit for all ne9nr proJects.All commercia!requirements must mest complfance
<br /> StGH PBRl4lIT Attach{2}sets af Eng3neered Plans.�
<br /> "'"PROPERTY SURVEY required for all NEW canstrucUon. �
<br /> Dlreatlons: _
<br /> Fill out applicatlon completely. '} � ', _.` _ r'
<br /> Owner 8 GQntractor sign back of applicaUon,notarized '� ;', ,� ? „ �, .. �. r�o.�.. :��»��.�.r,..� �,__..,,. , , .
<br /> If over�2+30Q,a Natice of Commenaement-is-reqaired. {AIC upgrades�over 57500 ''� `�"'�'``y jK i�}�'4 � .�
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<br /> . . ..0 j = , ;�;t.' �'�.%�;;C;,r^'r,r:��:.•i�:�:�)��•.,���.,
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<br /> Agent(for the con6ractor)or•Power of Attomey�(�o�,the_o,wn�[).would 6e sameane with nota�ized letter from own�r authoriiing same?'�� - �
<br /> OVER THE CCiUNTER PERMiTfiNG,;�� .;;.(Front:ofrAppllcatEoii Oniyj � -,;,;^� .,.. ... ..'� "''_,,�`�..'`"� ''�.:r..;:•.;�+;' ; ,
<br /> y4-' »,y�.Y�au..q.rY':`r:Na+s�wanu'i.�q�.LT.
<br /> Reroofs if shingles Sewers ����^Service�Upgrad�s AI,G'r`"�-�;Fences(PlobSurvey/Footage) ',
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<br /> Drtvewaya-Not over Counter ifion�pubiic`roadweys..�eeds ROW
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