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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> , Building Departrnent i
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<br /> Date Rec�ive� , � _ - Phone,ContacEfor�Permittfn � — i
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<br /> Owner'a Name � e� r�'O�ir1'er Phone Number ( �
<br /> Owner's Address � O ��t.k '��bwner Phone Number .
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<br /> Fee Simple TIt1eHolder,Name Owner Phone Number ' �
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<br /> Fee Simple Titleholder Address -
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<br /> JOB ADDRESS p �K �T � lr�lS �C'� LOT# r.�
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<br /> SUBDIVISION PARCEL ID# ` '
<br /> , (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED �NEW CONS7R ADD/ALT Q SIGN Q Q DEMOLISH
<br /> � .e. INSTALL B - • REPAIR
<br /> PROPOSED:U�ISE Q SFR Q COMM Q OTHER �
<br /> TYPE OF CONSTRUC170N � Q ' BLOCK ' 'Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK ��'� �h� e L� Yl. I
<br /> BUILDING SI2E � � � SQ FOOTAGE�, _ HEIGHT �
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<br /> QBUILDING $ VALUATION'OF�TOI'AL CONSTRUCTION � ` �
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<br /> QELECTRICAL $ - AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> �]PL�MBING $ ,-�Q o,� ' �
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<br /> QMECHANICAL $ VALUATION OF;MECHANICAL INSTALLATION �
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<br /> QGAS Q ROOFING Q SPECIALTY, Q OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> BUILDER COMPANY �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N' �
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<br /> Addressi ' � � License#
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<br /> ELECTRICl/W; , COMPANY ' '
<br /> SIGNATURE� '� REGISTERED Y/ N FEE CURRE�� 'Y/N
<br /> AddfAss, UcenSB# �
<br /> PLUMBER �I , � �j� COMP.ANY � � /`l S '� . �V�IYJ �
<br /> SIGNATURE, '- G�G�Lsl� � : ,REGISTERED. Y./ N.: FEE CURRE�` ' '" Y/N. � ' '
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<br /> Address c� 7 C( �v �� c�( �Z License,# - �C� T�� .
<br /> MECHANICAL� �� � � . .' � C.OMPAMf _
<br /> SIGNATURE•i � " ' � REGISTERED Y,,/.N ,� FEE CURRE� Y/�N
<br /> Address.'. -',; , ,_.�. � , ,.,; ._ � ' ' � ` � ,
<br /> License#
<br /> OTHER ," - - - � _ ' : `,COIIAPANY_ � . �
<br /> SIGNATURE ;- • "' �� � ` � ' � ' � 'REGISTERED � 'Y/ N.. Fee cuR�n ' Y/N
<br /> Addressj� , . ^ , . , .%� ,. � � " License# ;
<br /> RESIDENTIAL;• �Attacfi'(2),PIotP,lans;�(2)sets�.of''B'ullding"Plans;(1)set of-Energy=Fortns;�R=O=W�Permit for new construcUon,
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<br /> � �� -Minimum�ten��1.0�worktn da, ;�after;subinittal dafe.•..R� 'uired onsite;�ConstriicBon�Flans;Stormwate'r'Plans w/SIIt Fence installed,
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<br /> �� �Sanitary-�FaGllUes,&, ,dumpster,,Site•Work;Pertnit#orsubdiyisionsllargeprojeots� �,.;,._;- _ ' � �
<br /> COMMERCI�L Attach(3)`complete sefs'of Buildtng Plans�plus a'Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construcUon.
<br /> ; Minimum ten(10)warkfng days after submittal date. Requlred onsite,ConsUuction Plans,StormwaYer.Plans w/Silt Fence installed,
<br /> j Sanitary Facilitles 8 1 dumpster.Site Work Permit for all new:projects:.All commercial requirements:must meet compllance- �
<br /> . SIGN PERMIT AttacFi(2)�sets ofEnginee[ed;Flans„�.���� ' .. •:;�. :;.-� '
<br /> i{ ""PROPERTYSURVEYrequiredfor.all.NEW_construcUon. ,.
<br /> Dlrectlons: i .- . � _ . _ ' �
<br /> Fill out appiicatlon wmpletely. ,
<br /> Owner 8i Contractor sign back of applicatlon,notarized
<br /> If over���500,a Notice of Commencement is requlred. (AIC upgrades over 57500) '
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<br /> " AgeM(for th�e i:ontraotor)or Power of Attoriiey(fo�tlie�owner)would be someone wlth notarized letter from owner authorizing same
<br /> �VER THE COUNTER:PERMITIING- --. �(Front-of-Applicatlon•Only)- - �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drtvewaya-Not over Counter if an public roadways..needs ROW ' �
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