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<br /> s�aaeo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> i • Building Department
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<br /> Date Receiv I d r
<br /> i Phone Contact for Permitting • _ ,
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<br /> Owner's Ida�me �-� h��Ri' �c7 L` �N S Owner Phone Number 8�3 `�'�3
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<br /> Owner's Adc]ress � 3 3 a r7'c. r✓ /�u %a a 1�� Owner Phone Number I I
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<br /> Fee Simple Yitleholder Name Owrner Phone Number '
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<br /> Fee Simple Titleholder Address
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<br /> JOB ADDRE� S !�j�v �� N�`i s� .v J12 LOT#
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<br /> SUBDIVISIOPI PARCEL ID# �3-a�`�!- � /2a y bb 6 a0 � t�9¢o
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e , NEW CONSTR 8 ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP.OSED,IUSE Q SFR Q COMM 0 OTHER
<br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRANIE 0 STEEL Q
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<br /> DESCRIPTION OF WORK ��=� I✓��!z �' sw �/$i¢71'.+r� ,
<br /> BUIL'"DING SIZE SQ FOOTAGE� HEIGHT
<br /> � QBUILDING $ VALUATION`O�TOTAL CONS'PRUCTION
<br /> QELECTRIC $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
<br /> �PLUMBI $ �v v . O J , � r�.
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<br /> QMECHANICAL VALUATION OF MECHANICAL INSTALLATION
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<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED F,LOOR ELEVATIONS FLOOD ZONE AREA DYES NO
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<br /> BUILDER � COMPANY
<br /> SIGPlATUREi REGISTERED Y/ N . FEE CURRE� Y/N
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<br /> Address License#
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<br /> ELECTRICIAN COMPANY � �
<br /> SIGPIATURE ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � '
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<br /> PLUMBER � /�! COMPANY -SILL�vz� I,9 E % r'� �
<br /> SIGNATURE' �� `'L REGISTERED Y/ N � FEE CURRE� Y/N
<br /> _ Address .3���� ��S R-u►= 2-%fi�/> License#
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<br /> MECHANICAL COMPANY
<br /> SIGNATURE' ' REGISTERED � Y/ N FEE CURRE� Y/N
<br /> Addr'ess • ' License#
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<br /> A7HER `I COMPANY
<br /> SIGNATURE` � : REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address - - License#
<br /> "RESIDENT,IAL :-. Attaoh,(2).PIoY Plans;(2)sets of Building�Plans;(1)set of�Energy Forms;R,O-W Permit.for new construction, �
<br /> . � ; � Minimum;ten;(,10)working`.days aftersubmittal date. Required onsite;Construction Plans,Storinuvater Plans w/Silt Fence installed, i
<br /> ; Sanitary,F.acilities:&:,1�dumpster;Site 1Nork Permit for sutidivisions/large projects
<br /> COMMERCIAI: Attach'(2)`complete sets of Building Plans'plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> i Minim�m ten(10)working days after submittal date. Required_onsite,Construction Plans,Stormwater.Plans w/_Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance. �
<br /> SIGN'PERMIT Attach(2)sets of:Engineered Plans. '
<br /> i1 *"*"PROPERTY SURVEY required for aII:NEW:construction. �
<br /> Di'rections: �', �_ �
<br /> Fill out application completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A1C upgrades over$7500)
<br /> '" Agent(for the�cont�actor)or Power of,'Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE.COUNTER RERMITTING �"`�"'(copy of;contract"required),.-"��`'
<br /> Reroofs if shingles Sewers '' Senrice Upgrades,,A/C, • ,'Fences,(PIoUSurvey/Footage)
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<br /> Drlveways-Not over Counter;�if on.public roadwa'ys..needs ROW�. ' ,;
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