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<br /> s�a-�eo-oo2o City of Zephyrhills Permit Application Fax 813-T80-0021
<br /> ' Building Department
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<br /> Date Recelved . � Phone-Contact�for Permlttin �
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<br /> Owner's Nartae � Owner Phone Number �
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<br /> Owner's Address � �� �d � �=� Owne�Phone Number
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<br /> Fee Slmple Titlefiolder Name � • Owner Phone Number ' ;
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<br /> Fee Stmple Tltleholder Address
<br /> JOB ADDRE3S 3��t� Q�� � � Y' . �.3 S� LOT# �
<br /> SUBDIVISION PARCEL ID# ��I �Q" j� O O � d '�-Ic5 /O� -C�1�d
<br /> , - . (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPI SED � NEw CON57R ADD/ALT Q SIGN` `Q �Q DEMOLISH
<br /> INSTALL e ,- �REPAIR �
<br /> PROPOSED�USE Q SFR Q COMM Q OTHER � �
<br /> TYPE OF CON3TRUCTION - Q� BLOCK ' Q FRAME Q STEEL Q
<br /> DE3CRIPTION OF WORK" (�t/�� ,
<br /> BUILDING SIZE SQ FOOTAGE� .,HEIGHT}.�- �
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<br /> Q BUILDING $� �y. � VALUATIONwOF TOTAL CONSTRUCTION � '
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<br /> QELECTRIGAL - $ - AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C.
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<br /> QPWMBING $ ` .�� � �
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<br /> QMECHANICAL $ ' VACUATION OF'MECHANICAL INSTALLATION �I ' I
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<br /> Q�;i Q ROOFING Q SPECIALTY � OTHER `��
<br /> FINISHED FLOOR ELEVATIOiVS FLOOD ZONE AREA QYES NO
<br /> BUILDER _-�_ - COMPi4NY�� i�-.� �UC� �1 � (.� �v �,�
<br /> 31GNATURE � REGISTERED Y/ N FEE CUR Y/N ,
<br /> Addre�s 5 Cicense# �
<br /> ELECTRICIAN; , . COMPANY � - -
<br /> SIGNATURE, '� REGISTERED Y/ N FEE CURRE� ` Y/N
<br /> Address � -. . , LlcenS@# - '
<br /> PLUMBER ` ' , COMPANY � �
<br /> SIGNATURE` ' � REGIS.TERED. Y../•..N .•FEE CURRE� Y•/N ' �
<br /> Address � Ltcense.# . � � �
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<br /> MECHANICi4e: ' � C.OMPAWY. _ �
<br /> SIGNATURE ' • � � ' � ' �G1S7Etteo . , Y./ N FEE CURRER Y./-N �
<br /> Address� .. , ' � ` � a' � ' ' ' ' � License# ,
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<br /> OTHER •.� � .. . , � �;COMPANY " . , ,
<br /> SIGNATURE� -:- ' • -- `fi' �• " � � ' � ' REGISTERED� ` ' Y/ N . FEE CURRE�•� Y/N !
<br /> Addre� ,< ... . � . -.� ..r .� ,Y . � _ • License# ' �
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<br /> RESIDENTIAL.:t. -Attacfi"(2),-Plot%P,la"ns;;(2)sets:of Building'Plans;'(1)�set of-Ene'rgy=Foims•R=O=W Pertrilt far new constructlon, � ' �
<br /> �=i_� �;:Minimum;tent(;10);wo,rking;days;after;,submiftal date.°:R'equireii onsite;_Const'iuctlon=Flans;�Stormwater Plans w%S(It'Fence instelled,
<br /> Sanitary FaclllUes;&;�1,adumpsterSite..W.ork;P,ermit for subdivisions/large projects . ' ' "
<br /> - COMMERCI�L Attach(3)'complete sets'of Buililfng Plans plus a Ufe SafeCy Page;(1)set of Energy Forms.R-O-W Permit for new construction.- - �
<br /> �I Minimum ten(10)working days after submittal date. Requlred onsite,ConsUucNon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> i Sanitary FaGlides 8 1 dumpster.Site Work Pertnit for all newtproJecfs:All commerclal requlrements.must meet compllance �
<br /> SIGN PERMI'P Attach'(2)'sets ofEngineer.ed�Plans.,.��.�:._ �- " ._- ' '
<br /> +, """PROPERTY SURVEY reguired for aJl NEW construcfion. . •
<br /> Directlons: - . .. ' ;
<br /> FIII out a�pplicatlon wmpletely. ;
<br /> Owner B,Contractor sign back of applicatlon,notarized
<br /> If over�,2500,a Notice of Commencement is requYred. (AIC upgrades over 57500)
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<br /> Agent(folr the�con'tractor)`or Power of"Attomey(fo��tlie owner)would be someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER PERMITi1NG� - --� �(Front of-Applicatlon Only)�- � "
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drivewa i-Not over Counter if on publfc roadways..needs ROW ' � ' '
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