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<br /> 813-7f30-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> •' ' '�i� Building Department �
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<br /> Date Recelved� � Phone•Contact for Permittin � � I �
<br /> OwnePs Name' �� ✓7� N�� Owner Phone Number "n1� '"Z`"����z� �
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<br /> Owner's Address J"E�8 t4 �+,� • .a✓T ' Ow�er Phone.Number I ,
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<br /> Fee Slmple Tltleholder Name � � � Owner Phone Number �
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<br /> Fee Simple Titleholdec Address ° ;
<br /> JOB ADDRESS L �U l��� �(` LOT# �� '
<br /> SUBDIVI�ION /� (/'o o �r..� PARCEL ID# - •
<br /> - , ., (OBTAINED FROM PROPERTY.TAX NOTICE) '
<br /> WORKPROPOSED t NEw.CONSTR� ADD/ALT Q` SIGN' 'Q Q DEMOLISH '
<br /> � e INSTALL B , ,REPAIR . i
<br /> PROPOSED�U3E Q � SFR Q COMM ' Q OTHER �
<br /> TYPE OF CONSTRUCTION � Q� � BLOCK ' �Q FRAME 'Q �STEEL 'Q �
<br /> DESCRIPTIO�OF WORK w;,�, ��� �n ���eT' � I D 5�,� '
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<br /> BUILDING SIZE � C� • SQ FOOTAGE� . . HEI,GHT� �� � / �
<br /> BUIt�DING $ VALUATION'�FTOTAL'CONSTRUCTION % "
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<br /> EL�CTRICAL $ Q� • - AMP SERVICE �Q Q PROGRESS ENERGY � -W.R.E.C. !
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<br /> �PLUMBING $ ls� ' /��/i� �
<br /> q � J 7 '
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<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
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<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER�
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<br />, FINISHED FLOOR ELEVATIONS FLOOD ZOP1E AREA YES NO %�( �
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<br /> BUILDER � �
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<br /> SIGNATURE I, R G�isP�� Y/ N . FEE CURREN Y/N'.
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<br /> Address� % Llcense#
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<br /> ELECTRICI. �,s�. � ' �COMPANY ' • �
<br /> SIGNATURE� � � REGISTERED Y/ N FeE'Cuwte�° �Y/-N' '
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<br /> Address � , License# � - � �
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<br /> PLUMBER ' � COMPANY
<br /> SIGNATURE ' , REGISTERED Y I.N FEE CURREP " Y/N. �
<br /> IAddress� � _ :License,# . .
<br /> MECHANICAL , , .^ �
<br /> SIGNATURE " � ' ' �• � COMPANY.
<br /> REGISTERED Y./ N � FEE CURREP Y/�N - I
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<br />� Addres' F�_. _ , . .. ; `= � ' License# i
<br /> OTHER • _ - . � ,. ';COMPANY -
<br /> SIGNATURE ,.- .- ,,,� ,:: ,. .. , . � � . . , , , �...
<br /> ' �'REGISTERED " Y/ N . FEE CURRE� Y/N
<br /> �.I. ,lt- ._ . : ' . -
<br /> Addresg - � - - � '.' - , Cicense# � '
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<br /> R�SiD�FiTIFiL: •_-Attac�i'(2).:Plof�?la�is;,(2)sets o��Bullding�Plans;�(1)�set'of'En�rgy�Foirn§;�R=O-W=Perrriit-for naw construcUon,
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<br /> : Minimum:ten�(1,0);working'days;after"submiftal date."•Requlrei!onsite,�Coristiucdon Flans;'Stortnwate'r'Plans w/SIIt Fence�instelled,
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<br /> j� Sanitery FaclllUes:&.:1n,dumpste,r,-31te°.W.orktiPertnit fo,r,subdivislons/large:_proJects4, ;`.�;� � '� �
<br /> COMMERCIAL Attach(3)com'plete sets'of Builiitrig Pians'plus a'Life 8'afety Page;(1)set of Energy Forms.R-O-W Permft for new construction.�
<br /> I Minimum ten(10)working days'after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Siit Fence fnstalled,
<br /> �, Sanitary Facilides&1 dumpster.Site Work-Permit for all new projects.All commercial requlrements.must meet compliance
<br /> SIGN PERRIIAIT Attacfi(2)"sets'of`Engineered�Plans.:�� �;-� ;. .,, �
<br /> p ""PROPERTY SURVEY regufred for,all_NEW construction._
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<br />� Directlons: � . .-. , � '
<br /> Fill out applicatlon completely.
<br /> Owner&Contractor sign back of applfcatlon,notarized
<br /> If over 52500,a Notiee of Commencement is requlred. (AIC upgrades over 57500) :
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<br /> Agent(for the contractor)or PoYue�ofAttomey(fo�tFie�owner)would be someone with notarized letter from owner authorizing same
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<br /> DVER THE COUNTER:PERMITTING• -�- (Front of�ApplicaUon Only)� - ' ;
<br />' Reroofs if sh�ngles Sewers Service Upgrades A/C Fences(PIoNSurvey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways..needs ROW � �
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