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<br /> : � a�s-iso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 '
<br /> '� Building Department
<br /> Date Received , i frr� y
<br /> i� � 1! "r Phone Contact for Permitting " � c'7� - � �
<br /> Owner's Naml , � Owner Phone Number , ;
<br /> Owner's.Address Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone fdumber
<br /> Fee Simple T�tleholder Address � .
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISIOfd • PAItCEL ID# � ,
<br /> I � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK,PROPOSED . NEW CONSTR ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> , e' INSTALL B REPAIR '
<br /> ` PROP.OSED USE V Q SFR Q COMM � OTHER .
<br /> TYPE OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q
<br /> 4
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<br /> DESCRIPTIOtd"OF WORK
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT _ '
<br /> QBUILDING � VALUATION°OF'TOTAL-CONSTRUCTION 1
<br /> I
<br /> QELECTRICAL , $ AMP SERVICE' �Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ ����
<br /> I r�
<br /> QMECHANICAL $ VALUATIOfV OF MECHANICAL INSTALLATION `J
<br /> � �
<br /> QGAii Q ROOFING Q SPECiALTY Q OTHER ��78��/ �
<br /> l�
<br /> FIIVISHED.FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO '
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<br />� BUILDER ,��`.�H � t COMPANY � �i9�.3i�2 G;'p�o � S �/,`�� „a�
<br /> SIGNATURE ( ./�j� /� = � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address .��c��J'�c_,,yi�ibo�,tL,►�i4 /Y✓v,�. �Z-�/,,c4 License#`�raL � �
<br /> If . � ,
<br /> ELEC7RICIAN COhA PANY ;
<br /> i SIGNATURE i " REGISTERED Y/ N FEE CURRE� Y J N.
<br /> _ i
<br /> ;, .
<br /> Address
<br /> Cicense.#
<br />� PCUMB�ER.; COAflPANY� • �
<br /> SIGNATURE� REGISTERED- Y-/ N FEE GURRE� Y/N
<br />; Address License#-
<br /> � � 1
<br /> M ECHANICAL COAA PANY
<br /> � SIGNATURE� � REGISTERED Y/.N F.EE CURRE� _Y/N ;
<br /> - I , " • , - , . = �
<br /> Add�ess�� License#
<br /> ,,.i�-; -� '
<br /> O'iHER�� �"� ; " COMPAMY
<br /> SIGNATURE:�S, _. • • �-- REGISTERED Y I.N FEE CURRE� Y.I N
<br /> Address._ = a �=� ' � - � License#
<br /> ,�.
<br /> .;,RESIDEPlTIA�:::: 'Attacl%`(2j'Plot°Plans;':(2).sefs of$uilding•'Plans;�(1�)�set of Energy Forms;`R,O-W P,emiit�.for new.construction, ,
<br /> ,, ;,,s=..•�,��yY. •;Minimum':ten;,(:1 U)working;days after.su6rriittal-date. Required�onsite;'ConsWction Plans,Stormwater Plans w%Silt Fence installed,
<br /> � Sanitary;Facilities;&�;1=.dumpster;Site;Work Permitfor:.subdi'visions/large:projects=� ` -
<br /> COMRAERCIAL. AttacFi�(2)'complete"set"s'of Building`Plans�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence:installed, ,
<br /> j Sanitary Facilities&1 dumpster.Site Work Permit fo��all new projects.All commercial requirements must meet compliance _ �
<br /> '�:SSIGN-PERAAIY Attacfi�(2)�sets ofsEngineerQd Plans;k'. � . ' - ' i
<br /> ,{ ""PROPERTY SURVEY_requi[ed for aILNEW consUuction. , �
<br /> - - .. __. - - - i
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<br /> I "�';DIrBCtiOns: !I ,,.s r:�=.-':,.�.,: .r. ,
<br /> Fill>out application completely.
<br /> Owner&�Contractor sign back of application,notarized
<br /> If.over$2500,a Notice of Comm�ncement is required. (A/C upgrades over$7500)
<br /> .. .�.... ,�,�.y�, ';.
<br /> Agent(forthe'cont�actor)or PowerofAttomey(fo��tFie`owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING_. (copy.of-contract-required) ' �
<br /> �Reroofs(f shingles Sewers Service Upgrades PJC Fences(PIoUSurvey/Footage)
<br /> ! -., - . _ , i
<br /> Drlveways-Not over Counter if on public roadways:.needs ROW !
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