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a�sasaoo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � Building Department
<br /> Date Recelved ° Phone-Contact for;Permlttln — -
<br /> Owner's Name Owner Phone Number � � `� V
<br /> Owner's Address e � Owner Phone Number
<br /> Fee Slmple Titleholder Name � Owner Phone Number
<br /> Fee Simple Titlehold�r Addresa
<br /> JOB ADDRESS � � U 1 -'U � LOT# �
<br /> SUBDIVISION ' PARCEL ID# v`C�/ �'V '�� �"'
<br /> • � „ (OBTAINED FROM PROPERTYT NOTICE)
<br /> WORK PROPOSED • NEW.CONSTR , ADD/ALT Q SIGN� Q Q DEMOLISH
<br /> :B: INSTALL B REPAIR
<br /> PROPOSED..USE Q SFR. Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q- " BLOGK ' Q FRAME � STEEL Q
<br /> .?-=.
<br /> DESCRIPTION OF WORK � J I{�
<br /> BUILDING SIZE '� � - `SQ FOOTAGE� HEIGHT��
<br /> OBUILDING $ �y}.�` �� �� �-�� -. � ,
<br /> w VALUATION;:OF`TOTAL"COf�STRUCTION
<br /> QELECTRICAL $ ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING< $ - - �
<br /> '. , ���1 ,
<br /> QMECHANICAL $ VALUATION OF;MECHANICAL INS7'ALLATION. �
<br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER�- ,
<br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
<br /> �
<br /> BUILDHR COMPANY', ,
<br /> SIGNATURE v����,/ REGISTERED Y/ N . � 'FE RREA Y'/N
<br /> Address - - , ' License•# �
<br /> ,. - ., , - �
<br /> ELECYRICIAN_, .'COMPANY ` _ - •
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE�' = Y/N '
<br /> Address � , , _; Ucense_# `• = -
<br /> PLUMBER ' , COMPANY -_= � ^ � � -
<br /> SIGNATURE' ' � ; 4;REGIS.TERED � Y./<-N, .,: �,EEE CURRE� , . . Yn/N:.. .; �
<br /> Address .` � - . License# " • ,
<br /> MECHANICAL' � � , . � C.OMPANY " � ' ,.
<br /> SIGNA7URE- � �cIs7EReo , , Y/ N -' FeE CuwtEn� YJ.•N
<br /> Address'"�. _ . � , , , <. .,. Cicense#
<br /> OTHER � � `;COMPANY ` � _
<br /> SIGNATURE ` �; • ' ' ` ' REGISTERED Y/ N.__ . FEE CURRE� . Y/N
<br /> Addre�s � .� � � Cicense# -
<br /> ��:,.�,, :� ._. ..: . . _ ,. - r, "
<br /> RESIDENTIAL_,; :;Atta;cFi'(2)nPlotfP,laris;,(2)sets.of�Building;Plans;`(1)'sefof�Energy�Fo'rin's;��R=O-W Perrriltfornewconstruction, � '"
<br /> ;•-_-�Minimum,ten�(�1.0);,wo,rking,days;after"submittal`date:;.R`equired onsite;.'Constii,ioBonFPlans;Stormwate'r Plans w/Sltt Fence ins�lled,
<br /> � � '�v�SanitaryFaciltties;&?:1;dumpsterASite•Worlc�Permit.forsubdivislons/large�projects�, -_-;..�- � ' ' -
<br /> COMMERCIAL Attach(3)complefe se4"s�of`Buildfng Plans plus a'Life�$afefy Page;(1)set of Energy Forms.R-O W Permit for new constructlon.
<br /> Minimum ten(10)working days�after submithal date. Required onsite,ConsUuction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliHes 81 dumpster.Site Work Permit for all new projects.Ali commerciaLrequlrements must meet compllance
<br /> SIGN PERMIT Attach�'(2)sets of�Engi�neer,ed:Plans::<<�� ��= . � ` � ' �
<br /> ""PROPERTY SURVEY required for all,NEW consWction.:
<br /> Dlrectlons: � ..- � '
<br /> FIII out applicadon completely. ,
<br /> Owner&ConhacMr sign back of applicatlon,notarized ,
<br /> If over�2500,a Notice of Commencement ts raqulred,,�(N&:upgrades�over b7500) _ .- - �-- �-�;..,;;� ;, _
<br /> ��..,,;.;;, •. _;_.., ..:-�- ._ .. � _ ,_ >_.-�;,� � :-,-�_ -�- -- 1-,-, •..,:�::;: r
<br /> '" Agent(for ttie cont'ractor)'or'Powe�of Attoriiey'(fo�:tFie�owner)would•tie:someone with notarized letter from owner'authodzing same; � :t;
<br /> . � - . ;,; , -- .,,,,.;, ..
<br /> DVER THE COUNTER PERMITTING '� --•(Front•of App�lication:Only)�,- r� p ", �' ' ';`�,�;,. '. ,�' - E �
<br /> Reroots if shingles Sewers Service,Upgrades,,A%C _�.r.;Fences:�;(Pfo�Survey/Footage) � ` ..,_ � � �� _�,,. '_; ,
<br /> .... _ - � ,-- - - _ ,. . - .. ._.,.._ .--��- , .. . , � . � :,,,
<br /> Drivewaya-Not over Counter if on publfc roaduvays.:needs ROW�
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