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<br /> ,- s�saeIo-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � f ' � � Building Department
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<br /> Date Received j . > Phone Contact for Permitting" = �
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<br /> Owner's Name� � a, Owner Phone Number .
<br /> Owner's Address � �h Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number � �
<br /> Fee Stmple Titleholder Address
<br /> JO�ADDRESS � ✓� LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> � � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e _ NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR '
<br /> PROPOSED USIE Q SFR Q COMM 0 OTHER
<br /> � TYPE.OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q �
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<br /> DESCRIPTIOtd OF WORK V�, � "�� '
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<br />', BUILDING'SIZE ,SQ FOOTAGE� ,HEIGHT
<br /> QBUIL'IDING $ VALUATION°OF"TOTAL CONSTRUCTION'
<br /> QELECTRICAL , $ AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUi BING $ . � _/n
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<br /> MECHANICAL $ • VALUATION OF MECHANICAL INSTALLATION �l �
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<br /> QGA i Q ROOFING Q SPEGIALTY � OTHER �D�
<br /> FINISHED.FLQOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER COMPANY
<br /> SIGPIATURE REGISTERED Y/=N FEE CURRE� Y/N
<br /> Address License# �
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<br /> ECECTRICIAN COMPAtdY �
<br /> SIGNATURE ` REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Address Cicense.# � �
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<br /> PLUMBER,;,, I COMPANY� ' �
<br /> SIGNATURE� , �REGISTERED- Y.�/ N FEE GURRE� Y 7 N '
<br /> , Address' License•# � ;
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<br /> ,_ MECHANIC COMPANY �CQ�iV
<br /> SIGNATURE' " REGIS7ERED Y/,N FEE CURRE� Y -N
<br /> Addre'ss� License#
<br /> ,"•,i5i:'��, .. . . . . . . � .
<br /> OTHER�a � � ' " � COMPANY
<br /> .'SIGNATURE,t.i �� •- REGISTERED Y7 N FEE CURRE� Y/N
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<br /> Address;-. ' • � � • � ' ` License# �
<br /> ` RESIDENTIAL�':', Attac(i.(2)iPlot�Plans;�(2)ssets_of�Builtling�Plans;(1)setof°Ene�gy,Forms;R-.O-W.Permit.for.new.construction, I
<br /> � � •• y�Minimum;.ten��(.1'0)working!days afte�;§utimittal date. Required'onsite;�Construction Plans,yStormwater Plans w)Silt Fence installed, I
<br /> .,,'�•3?,.,t."yl : . . ., ., , � .
<br /> Sanitary„Facilities;&,1:dumpster;Site;W,ork Permitfor•subdi'visions/large:projects
<br /> :�,COMMERCI i. Attach`(2)'corripleCe sets of Buiiding�Plens plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence:installed,
<br /> � Sanitary FaciliUes 8�1 dumpster,Site,Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> '�3SIGN'PERAAIT� AttacFi�(2)setsof-EngineerQdPlans:�� '
<br /> I ""PROFERTY SURVEY required for_aII.NEW construcUon. - ,
<br /> ''-Directions:. i , <-. - • .. � _ _ _ ,
<br /> Fill:out application completely.
<br /> Ovirner&ConVactor sign.back of application,notarized
<br /> - if over$2500,a Plotice of Commencement is required. (A/C upgrades over$T500)
<br /> " Agent.(fo�tFie cont�actor.)-or Powerof Attomey(for ttie ouvner)would be someone with notarized letter from owner authorizing same
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<br /> �.'•OVER.7HE COUNTER_PERMIT-TING,.� � °:'(copy`.of;contraetrequlred) ' ' ,
<br /> Reroofs if shingles Sewers ,�Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter'if on public roaduVays..needs ROVV
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