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<br /> a��-�eo-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> f BuUding Department
<br /> Dateli�ae�iv�d� Phone�Contact�for•Permittin •
<br /> Owner's Naia�e - C4 �. I�S Owner Phone Number
<br /> Owner's Address �33'� p �n S� Owner Phone Number
<br /> Fee Simple Titlefiolder Name Owner Phone Number � ` '
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<br /> Fee Simple Titleholder Addresa - < - ; '
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<br /> JOB ADDRE,SS 3� 3�� �5�0`� /�v� " L-`.f`I� LOT# '
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<br /> SUBDII/ISI�N � PARCEL ID# . .
<br /> '� • � � (08TAINED F.ROM'PROPERTY TAX NOTICE)
<br /> WORK PRO�OSED_ NEw CONSTR ADD/ALT Q` SIGN� 'Q ��Q DEMOGSH �I
<br /> ��-e. INSTALL REPAIR • �
<br /> PROPOSEDI U$E Q SFR' Q �COMM Q OTHER ,
<br /> TYPE OF CONSTRUCTIOPI Q`' ° BLOCK '" Q FRi4ME [� STEEL Q �
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<br /> DESCRIPTION OF WORK' �YIS��� n� �a„ �n� L�t�trc Szrv�r�, `er'lti�� ��'15��h ;
<br /> BUILDING��IZE�` ° ` . � SQ,FOOTAGE�, � . . HEIGHT ,. Me'�r 'r °2�3��$g ;
<br /> QB�ILDING $ _ �, �. '
<br /> . � , VALUATION°OF TOTAL CONSTRUCTION -
<br /> QELECTRICAL $ . AMP SERVICE [� PROGRESS ENERGY Q W.R.E.C. !
<br /> QP.�UMBING $ �{ l�fi � S�i�'du/1 %� o�, , ;
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<br /> Q M��CHANICAL $ ` VACUATION OF MECHANI.CAL INSTALLATION. } i
<br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER• i
<br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> BUILDER p COMPANY �
<br /> SIGN/1TURE REGISTERED Y/ N . FeE CUR�� Y/N''
<br /> Address � � Gcense# �-
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<br /> ELECTRICI i. , • � ::COMPANY ` ' '
<br /> SIGNATURE ''` REGISTERED Y/ N FEE CURRe� `Y/N
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<br /> M{idres� _ ., , , License# =
<br /> PLUMBER f ,. • , - C.OMP,.ANY � ,
<br /> SIGNATURE� '� �, .REGISTERED Y./,N ` -�e cuRREn Y•/N
<br /> Address License.# :. �
<br /> MECHANIC,�� .A ` � . _ COMPANY � � _
<br /> SIGNATURE�� " ' REGI3TERED Y./ N � ,; FEE CURRE� Y,/•N I
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<br /> Address ' `.' � . , ` � --•-•-- License#
<br /> OTHER i� � � ,COMP/UfY, ; , 1 �
<br /> SIGNATURE' "'=� � ` REGISTERED Y/ N,. -FEE CURREh Y/N .
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<br /> Address ,'{�:;-4`. ,�'' _ ,.5 , , __ .Uoense# � ` "
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<br /> RESIDENTIAL:_,°-'.Atta:ch�(2)FPIot�Plans;,(2)"sets;of�Buildi`ng�Plans;(1)set'of-Energy=Forms;`RµO-W"Permitfor new c:onstruction,
<br /> ,.,Minimumkten;�(+.1,,0);,woriiing;days,after.`;submiftal'dafe.�-R'equired on`site;;Co`n'strticdon=Fians;-Storrnwater'Plans w%Sflt Fence installed, ,
<br /> Sanitery Faci'litles.&1,dumpsters§Ite Work.,Pertnit;forsubdivis(ons/large:projegts;_ .- - '` ' �' - '
<br /> r:�.- ::.,,... --..,,.._,. _.
<br /> COMINERCIAL Altach(3)�complete'seCs"of'Bulitling Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Permit for new constniotion. ' --
<br /> �': Minimum ten(10)working days'after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed,
<br /> �� Sanitary Facilitles&1 dumpster.Site Work Permit for all new,projecfs.,All commercial requlrements.must meet compliance '
<br /> SIGN PERMIT AttacFi(2)'sefs-of Engineer,ed�Pians..,�;-�-��'� • � � ,
<br /> "'•PROPERTY SURVEY raguired_fpr all NEW_constructlon..
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<br /> Dlrectlons• !' , + �:. , - ,
<br /> FIII out tipplicaUon completely.
<br /> Owner&Contractor sign.back of applfcaUon,notadzed
<br /> If over 1�2500,a Notice of Commencem�nt i�required. (A/C upgrades over 5T500)
<br /> '• Agent(for the i:ontracto�)'or Power of Attamey'(fo�`tlie�owner)would be someone with notarized letter from owner authorizing same
<br /> OVER'THE C`OUNTER PERMITTING --� - �(Front of�ApplicatiomOnly)-� '
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivew i ya-Not over Counter if on public roadways..need's ROW
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