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<br /> e�3-isaoo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . Building Department _ ,
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<br /> Dat�Re�eived � ��.. �
<br />�I � , �`� `� , P.hone-Con4act�for°Perrriittin ; �� .' �--3� �
<br /> CU Q��'� C-"'C�9 l��tY�s .`�
<br /> Owner's Name 1 1 Owner Phone Number --
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<br /> Owner's Address �,S �� '� Owner Phone Number •
<br /> Fee Simple TI�IeFiolderName � Owner Phone Number ' I
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<br /> Fee Stmple Titleholder.Address °
<br /> JOB ADDRESS - ��o��. � ` J� LOT# �
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<br /> SUBDIVISION ' ' ' PARCEL ID#
<br /> ' , ' � , . (OBTAINED F,ROM PROPERTY TAX NOTICE)
<br /> WORK PROP,I SED �NEw CONSTR ADD/ALT Q� SIGN �Q Q DEMOLISH
<br /> � .B. INSTALL B - �REPAIR �
<br /> PROPOSED.USE Q SFR Q �COMM Q OTHER
<br /> TYPE OF CON3TRUCTION Q � BLOCK ' Q FRAME � Q STEEC Q {
<br /> DESCRIPTION OF WORK � ' ���9� ���� �,L��. _-
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<br />, BUILDING SIZE I 1 '�O �� � SQ FOOTAGE C�. .,HEIGHT . � ,
<br /> OBUILDING $� c�� ' � � : � !
<br /> VALUATION`�OF�TOTAL�CONSTRUCTION �
<br /> Q EL�CTRICAL $ - AMP SERVICE - I
<br /> Q PROGRESS ENERGY 'Q W.R.E.C.
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<br /> QPLUMBING _ $ ' '
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<br /> QMECHANICAL $ - ' VACUATION OF'MECHANICAL INSTALLATION. . �
<br /> QGAS Q ROOFING � SPECIALTY; � OTHER - �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER ,) --='_� � �CbM�� �� CS�� -� C,
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<br /> SIGNATU � REGISTERED Y/ N FEE CURREA Y/N
<br /> Addre�s� ' License#' �
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<br /> ELECTRICIAN:. �COMPANY " - '
<br />� SIGNATURE; � REGISTERED Y/ N FEE CURREk ' �Y/N
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<br />� Address� � , . -. Ucense# ' '
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<br /> PLUWIBER I COMPANY-.; ' - - '
<br /> SIGNATURE'�� ' REGIS.TERED �
<br /> , Y/..N ,Fee cuwtEn ` Y•/N. �
<br /> Address . , " License,# : ' '
<br /> MECHANICAL � � COMPANY, �
<br />' SIGNATURE• - ' � '
<br /> REGISTERED , , Y./ N FEE CURRE� YJ�N ,
<br /> I Addresa��. ` • � • " - ' - License# _
<br /> OTHER ' - - • " � � ' `�COMPANY
<br /> SIGNATURE� �� ��° • • • ' ' ` REGISTERED � � Y/ N,. FEE CURRE� Y/N
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<br /> Address °". - ` „r �. - - � Ucense# � '
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<br /> RESIDENTIAL;;,-•Attach"(2),;Plot�P..lans;:.(2)sets�of�6'ulldiog�Pians;'(1)set'of-Energy�Foiiqs;R=0=V1►°Perrrilt for new construction, �
<br /> �� �� ; �Minimumiten-(1,0)Awo,rk(ng",days:after,;subriilttal'tlate:;_Requlred onsite;�Construodon`Plans;`Stortnwate�=Plans•w/Sflt'Fence�installed,
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<br /> ' Sanitary FacillUes;&,1��dumpster°Site•Woric;Permit for„subdivisionsAarge_proJeots; :' ;: ' �
<br /> CORARAERCi�L Attach(3)�complete se4s of B'uililtrig`Plans plus a Life Safetq Page;(1)set of Energy Forms.R-O-W Permlt for neW construotion. _ _
<br /> Minimum ten(10)working days'after submittal date. Required onslte,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles 8 1 dumpster.Site Work Permit for all new projects.All commercial requirements�must meet compliance
<br />! SIGPI PERMIT Attacti'(2)�sets of'Engineered-Flans� � <•^-� ; � .�-. , `
<br /> (' ""PROPERIY SURVEY reguired for,all NEW oonstruction.. _ '
<br />' Dlrectlons: ..'��_. __N .. i
<br /> Fill out appUcatlon completely.
<br /> Owner 8!IContractor sign back of appl(caUon,notarized ,
<br /> If over a2500,a Notice of Commencement is requlred. (AIC upgrades over 57500) � �
<br /> " Agent(fo��Ir the contrd'ctor)4or Powe�'ofAttomey�(for tFie owner)would be someone with notarized letter from owner authorizing same , a
<br /> DVER THE COUNTER,PERMITIING- �-.-- �(Front of•ApplicatioreOnly)- �� ` � ���
<br /> Reroofs if shiigles Sewers Servlce Upgrades A/C Fences(Plot/Survey/Footage) •
<br /> Drivewaya-Not over Counter if on pubflc roadwa"ys..needs ROW
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