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813-7810-002o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> + � � Building Department
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<br /> Date Received I, . _ Phone,Contact for,Permittin —
<br /> Owner'�Namell, �v'1 �l r I��1 i � '�a�.. ���'� Owner Phone Number � : ��� ���
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<br /> Owner's Address ��� �� `��� �` � �ner Phone Number - �� '
<br /> 'I ' Owner Phone Number � �
<br /> Fee Slmple Titlaholder Name ' ,
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<br /> Fee Simple Tit�i holder Address " '
<br /> JOB ADDatES� � c�`"! ���� � �i LOT# C�
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<br /> SUBDIVISION�� PAItCEL ID# � "
<br /> WORK PROPOSED , •��,NEw CONs7R . `. ADD/AI 1' � SIGN NED FR�OM PROPERTYT�rice)DEMOLISH
<br /> � 'e. INSTALL B .. ,REPAIR �•
<br /> PROPOSED�USE `-y SFR Q 'COMM ` �] OTHER
<br /> TYPE OF CONSTRUCTION � ��'' '�BLOCK ' Q FRAME �-� STEEL Q
<br /> �escRi�nori oF woRK �e q�'� T�oo� ��nnoV 2 � r ►.iS�ra.c�� ►��e�.•S sh��g S
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<br /> BUILDING'SIZE ; ' �" SQ FOOTAGE��, . �.HEIGHT
<br /> QBUI�DING $ n ` L1 O� ° VALUATION:OF TOTAL CONSTRUCTION �
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<br /> �ELE�TRICAL ,, $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPL��BING $ - ' �
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<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION , I �
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<br /> QGA Q RO.OFING .Q �SPECIALTY Q OTHER� �J ���
<br /> FINISHED FL�OR ELEVATIONS FLOOD ZONE AREA QYES NO r/
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<br /> �� ,�� �i � ��u���,t coa�Parnr �coM� 0����
<br /> BUILDER �JV,'� L/�
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre�s � � Llcense# '
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<br /> ELECTRICIAN� � �'COMPAPIY� - �
<br /> SIGNATURE ' �` REGISTERED Y/ N FEE'CURRE� ' ` `Y/N
<br /> Address � ` : . � �, / License# .�
<br /> PLUMBER COMP,,ANY � �
<br /> SIGNATURE' , REGISTERED Y/,--N .FEE CURREk Yr/N.
<br /> Address' � �Llc:ense# � •
<br /> MECHANICAL - , COMPANY
<br /> SIGNATURE , �}- ' ' ' � REGISTERED � Y,./ N , FEE CURRE� Y,IrN :
<br /> Address ' - � , � �` ` ` `� � ' - � -, � � Cicense# ' .
<br /> OTHEIt � . .� � - . , ` �,'COMPANY - .
<br /> SIGNATUI2E^'"• � � �- �f ' " ' ' "' `REGI$TERED Y/ N_.� FEE CURRE� Y/N
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<br /> Addreas' � -' ��, = '' ,-� . , - � Cicense# .
<br /> RESIDENTIAI�,a<. .Atta'ch;''(2)�P:,lot%P:,lans;..;(2)sets�-of=Building Plans;`(1)set of�EnergyaFoRns;�R=O=W'Penrilt for new constructlon,
<br /> „ ,,;A.;-MinimumEtep;(1:0)„worliing;days afterrsubmlEtal date.:�;R`equi`retl onsite;<ConsUucdon=Blans;�Stor'mwate��Plans w7 Sflt Fence instelled,
<br /> 4�SanitaryFacillUes,8r.l�dumpster,�8lte;Work,:P...ermit;forsubdivisions/largeprojects;; •: �• " '" ' � � "�
<br /> COMiNERCIA��. Attach(3)complete set's`of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R O-W Permit for new-construc8on.
<br /> �' Minfmum ten(10)warking days after submittal date. Required onsite,Con'sUuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> I� Sanitary Facilitles&1 durnpster.Site Work Permit for all ne�wprojects:All commercfal requirements,must meet compliance
<br /> SIGN PERMI�I Attacfi(2)sets�ofEng,i;rieered�Plans.;::�•��.�-- . : _ �-� .. • ' �
<br /> ""PROPERTY SURVEY required for all NEW construcUon..
<br /> DlrecNons: � .-��.��}°'.` � ,
<br /> Flll out applicaUon completely.
<br /> Owner BI�Contractor sign back of applfcatlon,notarized
<br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over�7500) - �
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<br /> Agent(f II the cantractor)or Power ofAttomey:(fo��ttie�owner)would be someone with notarized letter from owner authorizing same
<br /> �VER THE CiOUNTER,P.,ERMITTING,..' �-`(Front of Application Only)- t, 4 �`1 , , . ..�_. , ._ .
<br /> Reroofs if shi�gies Seweis l � Service Upgrades.A7C ;:�� Fences(Plot/Survey/Footage) _ _ ; ' , ..
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<br /> Drivewaya-Not over Counter if on public roadways Yneeds ROVV t. ,, . ,
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