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a���ao-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br />� I' Building Department
<br /> Date Recelved -
<br /> -i� �� Phone-Contact for Permlttin - —
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<br /> Owner's Nanie �PS�( eTNC�/�Gi� Owner Phone Number �� 7 r � '� �
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<br /> Owner's Address .� �� _L Owner Phone Number
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<br /> Fee Simple Tltleholder Wame • Owner Phone Number •
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<br /> Fee Simple Tltleholder Address � ,
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<br /> JOB ADDRESS � S � (i(.7C� LOT# �
<br /> SUBDIVISIO� PARCEL ID#
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<br /> li • (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED •. ,NEW CONSTR' ADD/ALT �Q` SIGN' Q � Q DEMOGSH
<br /> �� e. INSTALL B. . REPAIR
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<br /> PROPOSEDlUSE Q SFR. Q COMM Q OTHER — �:JCC �
<br /> TYPE OF C�NSTRUCTION Q BLOCK '' �Q FRAME ;Q STEEL 'Q
<br /> DESCRIPTION OF WORK Y,.L �l�-rlG� J�e� .�L
<br /> � �I � VC N l r��IfGCC I`eti1C� � �
<br /> BUILDING SlZE� SQ FOOTAGE�. HEIGHT
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<br /> QBUILDING $ U�o v� VALUATION:OF TOTAL CONSTRUCTION � "
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<br /> QEL�CTRICAL $ � . AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OP�MBING $ -
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<br /> QM6CHANICAI $ VALUATION OF,MECHANICAL INS7'ALLATION.
<br /> Q�SQ ROOFING . SPECIALTY . OTHER � �`� � 1
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<br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
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<br /> BUILDER COMPANY� � /�S e w Q �� C�
<br /> SIGNATURE� REGISTERED Y/ N �FEE C �n Y/N
<br /> Address � � , �
<br />, j 3 ��' � l'� Clcense#
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<br /> ELECTRICIAN_ . COM PANY
<br /> SIGNATURE� � REGISTERED Y/ N FEE CURREK Y/N �
<br /> Addre� ` , . ' - . ' , License#. Q
<br /> PLUMBER ` � , COMPANY •
<br /> SIGNATURE " . REGI3TERED Y./ N-. . , ,,FEE CURRE� Y•/N. ' "
<br /> Address License,# "
<br /> �MECHANICAL � ; , • COMPANY
<br /> SIGNATURE� - ' � REGI§TERED Y./ N . FEE CURRE� Y./��N
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<br /> Address � - - � � �. License#
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<br /> OTHER :� . . " .. , ;,COMPANY ,
<br /> SIGNATUREI. -:=' : ' -' '� � ' � � REGISTERED ' Y/ N : FEE CURREh Y/N
<br /> Addreas , , , , ' �L'icense# � - - J
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<br /> RESIDENTIAL i;�a Attacfi'(2)�Plot%P.,lans3�.(2)sets.of�Bufliling:Plans;'(1)sef of•Energy>Fortns;�R-O-W Permit far new consUucUon,
<br /> -�'� ;:Y; Minimum;�ten;,(�1,0);worktng;days..after.,;subriilfhal date:�R'equtred onsite;;Gonstnic8on`Plans;'Stormwater'Plans�w/Sllt Fence lnstalled,
<br /> � � �Sanitary Facilitles:&;.1,,dumpsterSite Wor1c:;Permit;fcr su„bdivisionsAarge:pro)ects: ' ' '
<br /> COMMERCIf>L Attach(3)�eomplete sefs of Building Plans plus a Life�Safety Page;(1)set of Energy Forms.R-O-W Permit for new constniction.
<br /> j Minimum ten(10)working days after submittal date. Required onslte,Constructlon Plans,Stortnwater Plans w/Siit Fence installed,,
<br /> Sanitary FaciliNes&1 dumpster.Site Work Pertnit for all naw projects..All commercial requlrements.must meet compliance
<br /> SIGN PERMIT AttacFi(2)'sefs"of Engfneer.ed�Plans.,,•� } _ � . , _ '
<br /> � ""PROPERIY SURVEY requlred for all_NEW con.s.tnicUon.. .
<br /> Directlons: ' , - -- '
<br /> Ffll out applicaUon completely.
<br /> Owner F�Contractor slgn back of applicatlon,notarized
<br /> If ovar Si2500.a Notice of Commencement is requlred. (AIC upgrades over s7500)
<br /> " Agent(for the canUactor)or Powe�ofAttomey(fo�tFie owner)�would be someone with notarized letter from owner authorizing same
<br /> DVER'THE COUNTER.PERMITTING- •-��(Front of Appllcatlon Only) -• � �
<br /> Reroofs if shingles Sewers � �Service.Upgrades;'A�/C`' °Fences;(PlodSurvey/Footage)
<br /> Drivewaya-Not over Counter'.'(f on�putiiic roaduvays.ineeds ROW. ��f�:f�
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