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� 813-7so-oo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � Building Department
<br /> iI'
<br /> Date Receive Q
<br /> � Z� I � � Phone Contact for Permitting � ��� �-� - � �� O
<br /> Owner's Nam e �� �.� w; Owrner Phone Number . /3 7�����1 �
<br /> Owner's.Addr ss ✓r•� 2 �/ p I� -�Tr�C�F Owrner Phone Number
<br /> Fee Simple Tit eholder Name Ow►ner Phone Idumb�r
<br /> Fee Simple Ti eholder Address
<br /> JOB ADDRES S- (�� �o �� S��r P�,� LOT# �
<br /> SUBDIVISION- PARCEL ID#
<br /> , - (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK;PROP SED . NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> B INSTALL e REPAIR
<br />, . PROP.OSED U E _ Q SFR Q COAAM 0 OTFiER
<br />' • TYPE:OF CON TRUCTION Q BLOCK - Q FBAME 0 S,TEEL Q ,.-
<br />, � i � 1 .
<br /> DESCRIPTION OF WORK � V c I C�!�� �L�.l- �„+s�'1� �� h e v-' 2 rIi ,.�tn (IS-SrG'� ,(� � -l� S �-
<br /> @UILDING`SIZ SQ FOOTAGE ��,LI..� Sy�
<br /> =.HEIGHT
<br /> OBUIL ING $ VALUATION�OF"TOTAL CONSTRUCTION '
<br /> QELE TRICAL , $ AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C.
<br />� OPLU BING $ � � ��
<br /> MEC ANICAL $ VALUATION OF fVIECHANICAL INSTALLATION � �
<br /> � �.SS—p o p
<br /> QGAS Q ROOFING Q SPEGIALTY 0 OTHER ? � �?�
<br /> FINISHED FLO R ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y 1`N FEE CURREn Y/N
<br />', Address License#
<br /> : .
<br /> ELECTRICIAN CONIPANY �
<br /> SIGfdATURE �' REGISTERED Y/ N FEE CURRE� Y./N
<br /> Address ° Cicense.:#. . �
<br /> PLUMBER.:;. COMPI4NY
<br /> SIGNATURE � . �REGISTERED- Y/ N FEE CURRE�- Y/N
<br /> _ Address License•#` � '
<br /> =: AAECHi4WICAL `� r� / COMPAIdY `/ � w) � ���1 j -� C
<br /> '� .SIGNATURE' � �/. REGISTERED , Y/ N FEE CURRE� Y/N
<br /> Add�ess<< � - ' . License# C � ���Sf��
<br /> ,�:iii�.'r�, . .. . � ,
<br /> OTHER�'� `'`�r � COnAPANY � �
<br /> 'SIGNATUREr?.i •' -' " � ' ' REGISTERED Y I.N FEE.CURRE� Y.I N
<br /> ;;�_y ... a . � _ ,_
<br /> Address;� _ �":� .:F.sa, .`;:° - � - - - ' ' L'icense#
<br /> �`.RESIDENT'114L!.:,; Atfacfi`.(2)iPlot=`Plans;(2):seCs-of�Buildirig�Plans;-(1�)set'of°Energy,Forms;�R,O-W P,errriit,for new.construction, .. -
<br /> �._ � , -~�. �Minimum�.tent_(,1 U)wo,rking;day,s afte�_sutiiriittal date. Required�on'site;'Con'struction Plans,Stormwater Plans w/'Silt Fence installed,
<br /> • �`�,��, � �Sanitary,,Facilities<&�,1:.dumpste,r•;Sife;W.ork�Permit for subdivision5/large`projecfs�` � � � � '
<br /> s..COMMERCIAL Attach�(2)�complete"se4s'ofBuilding�Plans'plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,.
<br /> - Sanitary Facilities 8�1 dumpster,Site Work Permit fo�•all nevu projects.All commercial requirements must meet compliance
<br /> .. _.__.. ... . . .
<br /> ;��$IGN PERRAIT AttacFi`(2)sets of�,Engineergd Rlansi!•� -•;
<br /> - - "*`•FROPERTY SURVEY required for_aII..NEW coristruction. �
<br />, "�Direct"ions: , . . -,. � . . , _ ,_.
<br /> � FiIC'out app ication completely.�^.
<br /> i Ovuner& ntractor sign back of application,notarized
<br /> i _ If over$25 0;a Notice of Commenc�ment is required. (A/C upgrades over$7500)
<br /> "' Agent(fo�`��'e�cont�actor)�or-Power of Attomey(for tfie owner)would be someone with notarized letter from owner authorizing same
<br /> :�OVER:T'HE CO ,NTER:PERMI,T.•TING _ (copy..of-contraet-required) " ' -
<br /> `Reroofs if shingl s Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> _ ..�.,. �' , .
<br /> Drlveways Not over Counter if on public roadways..needs ROW
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