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813-780.0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Departrnent
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<br /> Date Recelved • a,�� _ �b
<br /> - � Phone-Contact•for�Permlttin /
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<br /> Owner's Name �� `�iv� �/ Owner Phone Number �
<br /> Owner's Addre s �B � Q �' /L�S s- Owner Phone Number -
<br /> Fee Simple Tltleholder Name • ' Owner Phone Numb�r
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<br /> Fee Simple Titleholder Address ^
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<br /> JOBADDRES �(��� �l ��`LL4� LOT# �
<br /> SUBDIVISION � PARCEL ID# U� �� � � �D � '
<br /> � , (OBT/UNED F,ROM PROPERTYTAX NOTICE)
<br /> WORK PROPO ED • NEW CONSTR ADD/ALT Q` SIGN' `Q Q DEMOLISH
<br /> ;B. INSTALL � ;REPAIR
<br /> PROPOSED.0 E Q SFR Q �COMM ' Q OTHER
<br /> TYPE OF CON TRUCTION Q� 'BLOCK ' Q FRAME � STEEL Q
<br /> DESCRIPTION F WORK L� Cir11�/v fi Du.� � p % /
<br /> BUILDING SIZ � SQ FOOTAGE� , HEIGHT �
<br /> Q BUIL�ING $ VALUATION:OF�TOTAL CONSTRUCTION ' '
<br /> QELE RICAL $ � t AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> t .
<br /> QPLU BING $ '
<br /> QMECHANICAL $ ����, � VALUATION OF;MECHANICAL INSTALLATION
<br /> QGAS Q ROOFING .Q SPECIALTY r] OTHER
<br /> FIIVISHED FLO �R ELEVATIONS FLOOD ZONE AREA QYES NO _ �
<br /> BUILDER COMPANY` '
<br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N
<br /> Addres� � L'-icense#
<br /> ELECTRICIAN< . � COMP/WY ' � �
<br /> SIGNATURE �' REGISTERED Y/ N FEE�CURRE�'=� Y/N
<br /> Address ' , , _ License# '
<br /> PLUMBER , COMPANY �
<br /> SIGNATURE' � � , .,REGIST.ERED Y./-N•. - ,FEE CURRE� Y/N �
<br /> Address License,# �- ��
<br /> MECHANICAL` ' -" r � . ' aonnP�u�nc i�J-/f�5_ �'. AN�.G�-tg/��TN�
<br /> l�rx� ���'�.�ii�
<br /> SIGNATURE REGISTERED Y.,/ N FEECURREt� YI�N` -
<br /> Address� � � �`�el�°, `. ��/11;j ��� License# e��'t7�.3�I�d
<br /> OTHER '' �� � - � ' ;COMPANY ..
<br /> SIGNATURE = � �� � �� �� � � REGISTERED Y/ N,.,. FEE CURRE�•_ Y/N
<br /> Address - - - � ' .s ; Ucense#
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<br /> RESIDENTIqL:,, �•Attacfi':(2),Plot%P,laris;:.(2)sefs�.of�Building``Plans;`(•1)set�of�Energy=Forms;�R=0-1N Permlt for`new construcUon,
<br /> -, ;. :-Min(mumyten.(10)worlEtng;day,s_after'submlEtal"date:`Requlreif onsife,'Con'strucdon-Rlans;�3tormwaterPlans w%Sflt Fence installed,
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<br /> Sanita' FaciltUes:8��l;dumpste.r,°81teWork.PermitforsubdiWslo�s_/large�_pro)ebts�: , ;: ' ' � � •
<br /> ry ;. .
<br /> COMMERCIAL Attach(3)�eomplete sets`of B�uilding Plans'plus a�Life�$afefyr Pege;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - Minimum ten(10)working days after submittal date. Required onsite,ConstrucGon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilidas&1 dumpster.Site Work Permif for all naw;projects:All commerclal requlrements.must meet compllance -
<br /> SIGNPERMIT AttacFi(2)sets"ofEngineered;Plans:. .�.. . �. -.- � `
<br /> ""PROPERTY SURVEY reyuirecl.for all NEW constructlon. ' '
<br /> Directlons: ..-".•:.;. , ., • , �
<br /> Ftll out eppli, don completely.
<br /> Owner 8 Co tractor sign back of appltcatlon,notarized
<br /> If over a250 ,a Notice.of Commencement is required. (A!C upgrades over 57500)
<br /> " Agent(for th�contractor)or Power of Atfomey�(for�tFie owner)wrould be someone v+rith notarized letter from owner authorizing same
<br /> �VERTHE COU�TER.PERMIT'TING���-w-.�Fro[�t_o�Ap.pl�c�ttq.�„Only)k,.<«-_•%_•; - ,�a��;;r.m:��.�►�x�,�,earw�b..�•
<br /> Reroofs ifshingle Sewers ,�' Seni�ge��pgrades_�A/.0 Fences�.(Flot%Survey/Footage) � _,J�;+�=�.1k.;7 �r'aE�d;�; .:� "t�•�,,,
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<br /> Driveways-Not over Counter�f on`public roadvYays:.needs,ROW: P , �s , ��`+ � �(A��` '
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<br /> afii' :i Ih�^'fea.,�,�:h''l' '., .,�� ' � .q2$�`+�K?�'r�:iint�i$�% ;ii;J•i�i D'3iifffi �°�.i'r,�'a�.i� �
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