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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ., Building Department
<br /> Date Recelyed �: Phone Contact for:Permittln — '
<br /> Owner's Name � L�/�� �G���r Owrner Phone Number � O � v
<br /> Owner's Address � (%� ������� Owner Phone Numiser
<br /> Fee Slmple Tltleholder.Name Owner Phone Number � � ��
<br /> Fee Simple Titleholder�a►ddress
<br /> JOB ADDRESS ✓�/ Q %� C�T ���l� �{l�'� � LOT# ��
<br /> SUBDIVISIOId - PARCEL ID# � ' • �
<br /> . . � (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED '-NEW.COPIS7R ADD/ALT � SIGN'� Q Q DEMOLISH
<br /> B.- INSTALL 8 REPAIR � "
<br /> PROPOSED:USE Q SFR Q COMM' - Q •OTHER '
<br /> TYPE OF CONSTRUCTION Q BLOCK ` 'Q FRAME � Q STEEL Q
<br /> DESCRIPTION OF WORK + C�N/� �C� Q /�.� � %`/� '/✓/� /�(�%Q
<br /> BUILDING SIZE � 3Q'FOOTAGE�, : ..HEI,GHT�. .. .
<br /> QBUILDING $ , .,,4..:..�-..: . .�.•._. ....� " ,• .
<br /> VALUATIOiU,:OF�TOTAL COIySTRUCTION
<br /> QELECTRIGAL $ ` AMP SERVICE Q 'PROGRESS ENERGY Q W:R.E.C.
<br /> QPLUMBING , _` $ � _� -` b�(1�
<br /> 1 v
<br /> QMECHANICAL $ VALOATION OF;MECHANICAL INSTALLA'1'ION. �
<br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD zONE AREA QYES_ ,NO
<br /> .,
<br /> BUILDER � COMPi4NY� � N(�NI� "` '' L-Y���
<br /> SIGNATURE REGISTERED Y/ N 'FEE Curt�� Y/N
<br /> Addresa � - - L(cense-# �
<br /> ELECTRICIAN � ,=COMPANY ' ' --
<br /> SIGNATURE ' REGISTERED Y/ N FEE CURRE�` ' -'�Y/N' '
<br /> Address ' - � _ . , � .:� License.#� °
<br /> PLUMBER ` . . COMP.ANY -_= �
<br /> SIGNATURE' ` � � ; REGI3TERED� .- Y/,.N„ : �,FEE�CURRED; .:.'� Y•/N. _ : ,
<br /> Address ' � � License# �
<br /> MECHANICAL' ` " ' .� � COBAPANY - -
<br /> SIGNATURE t - REGISTERED , Y_/ N._ . � FEE CURRE� Y/-N,
<br /> Address-` - ' - ' �� � � License# � .
<br /> OTHER = � � ,�tCOMPANY �
<br /> SIGNATURE '"- �� '� � " ' � ` REGISTERED Y/ N.,� � FEE CURRE� Y/N
<br /> - Address, � - ' . . ' License#� .� ' - I
<br /> RESIDENTIAI;,,, ;Atta'ch�(2)APIot�Plans;..(2)set"s�.of�Building Plan's;(1)'set`of�Energy�Fortns;`R=0-W'Permltfo�new construction, �
<br /> .;;=w Minimum�ten;(:10)�,u±ro�ing;days;.after,„submittal`date:�.Required onsife,%Constiucdon�Plans;Stormwate�"Plans w/SIIt Fence installed,
<br /> ;. +.._ �,4, "' ' , y '
<br /> ��Sanitery Facilifles;8�'�1.;dumpster.Site�Work:P,ermitfor,subdtvisions/large';proJects4,_ .� -�= � �
<br /> COfNMERCiAL Altach 3`com lete se4`s"ofsBuildi'n'� Plans "I'us a Ufe Safe �Pa e; 1 set of Ene Forrns.R-O-W Permit for new consUuction.
<br /> � ) P 9 P tY 9 � ) r9Y
<br /> Minimum ten(10)worktng days'after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new.proJects.All commercial.requlrements_must meet compllance
<br /> SIGN PERMIT Attach"(2)'s"efs of"Eriglneer,ed�Plans:, � � _ � � �
<br /> ••••PROPERTY SURVEY reguired,for al(NEW constructlon.. _. _
<br /> DlrecHons: ,. � , �
<br /> Fill out applica8on completely.
<br /> Owner&Contractor sign back of applicatlon,notarized
<br /> If over SZ500,a Notice of Commencement is required. (AIC upgrades over 57500)
<br /> ;.+��.:�,:�::.:-
<br /> " Agent(for the contractor)'or'Power of Attomey(for tFi'e owner)would be someone with notarized letter from owner authorizing same . _
<br /> DVER THE COUNTER PERMITIING� --;,(FronCof-ApplicatlonOnly),� r� - � � +'� '''� = ' '• . , .
<br /> Reroofs if shingles Sewers Service Upgrades A/C� Fences,(Plot/Survey/Footage) -�� � - �''t'- �� �" -.' ��:' .
<br /> ... _ -. . , ., , . :�.r;�. i�..,.: ,.:% . ..,
<br /> - b . .. , . ;e::� -`' � , ,- . �„ .� � . ,- � ' ' '
<br /> Drivewaya-Not over Counter if on publfc roadwiays::need§,ROfN� - � ' ��� � .___.- - .__,_, s-. .�,� - ,,�,.: .,. .-....- ...
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