813-780-0020 City of Zephyrhills Permit Application Fax-813-780-Od21
<br /> • Building Deparkment
<br /> Date'�teceive�� f + (� ( �,
<br /> 4, Phone Contact fcr Permitting ��� ���_ �`�' `�
<br /> Owner's Namll r`�1��� S�Sb n �PSi VI i Owner Phone Number ��J �� � ��� " �-�� Z
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<br /> Owner's Addr,ess � S OwnerPhane Number
<br /> II �Fee Simple 7ltleholder Name �_ � Owner Phone Number �!
<br /> Fee Simple T��tleholder Address
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<br /> JOBADDREIIS t2��� S� ��h,S ���'"1 LOT#
<br /> susa�vrsioiv S�1.0� �` ��..(c5 paRc���a# �3— ��—�l— �!(�1�.— 6��?GC�—C7 �/{�.
<br /> II �T�P,� G/\.!S Cj"�..E}V PH� � � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK RROPOSED NEw CONSTR ADDIA�T C� StGN Q Q DEMOt�tSN
<br /> II � INSTALL 8 REPAIR
<br /> PROPOSED USE o ��� o CONIM �� QTHER
<br /> TYP.E'OF CO STRUCTION Q BLOCK • Q FRAME [�� STEEL Q
<br /> DESCRIPTIO OF WORK ����`�'�' ���� � `S i n �
<br /> BUILDING SIZE � � SQ FOOTAGE[,_,_,� HEtGH7 � ����
<br /> QBU��QING $ Z�-0� a�� VALUATiON OF TOTA!CONSTRUGTION ���������
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<br /> [�ELECTRtGAL $ AMP SERVICE Q PRO�RESS ENERGY � W.R.E.C.
<br /> QPl,�M81NG $
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<br /> QM�CNANICA� $ VALUATlOtV QF MECHANICAL tNSTALIATIG}N �✓�
<br /> OG�S Q ROOFING Q SPEGIAt.TY �� OTFiEE2
<br /> FINISHED FL�OOR ELEVATIQNS r�� FLOOD ZONE AREA [�YES NO
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<br /> BUILDER ��'(��7/1,� �� COMPANY
<br /> SIGNATURE� � ��' REGISTEREp Y/ N FEE CURREI� Y/N
<br /> Address License#
<br /> , ELECTRICI�,N COMPANY �
<br /> , SIGNA7UR� REGISTERED Y/ N FEE CURRE� , Y/IV
<br /> � Address Cicense# �! � �
<br /> PLUMBER. COMPANY
<br /> SIGNATUR -REGISTERED Y�/ N- FEE CURRE� � Y'I N
<br /> Addres� v � ' Lioense#`_� �
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<br /> � MECHAPIIC�IL CQMPANY
<br /> SIGNNITUR�` REGISTEREp +„ Y/ N FEE CURRE� Y/N
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<br /> Add'ress � '" L•icense# �� � ,
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<br /> or�rE���� � � ,� c,c►nn�i�`ir � -
<br /> SIGNAT:URI=,. REGISTEREp , Y/.N , . FEE.CURRE�' . Y,/N
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<br /> Addreist - - - " License# �— �
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<br /> '.RESIDEidTiliAl..'�' Attacfi{2):Plof Rlans;`(2}sets of'Buitding�Ptans;{'t}set of�Esergy Forrrrs;R-O-W.Pemiit for new.construction,
<br /> �� � ����a t �Minimum�ten.(>10)working�days after.�submittal:date. Requir'ed onsite,�Con'struction Plans,Stormwater Plans w/Silt Fence installed, _
<br /> Sanitary,Facifities.&�r1�.dumpster;Site:Wortc.Permit for:subdivisionsflarge projeats �
<br /> :-...COMMERCItAL Attach=(2)`corripiete sets of 8uiiding Plans plus a L�fe Sa#ety Paga;(1},sef of Energy Forms.R-O-W Permii for new constructlon. -- -
<br /> � Minimum ten(10)working days after submittal date. Required onsite,Gonstrucfion Plans,Stormwater Plans w/Silt Fence instailed;
<br /> � Sani#ary Faci(ities&1 aumpster.8ite Work Permit for att new pro}ects.Ali cammerciat requirements�must s'neet-camplian��- -
<br /> ' .SIGN PERIIfliT i4ttach(2)sets o.f:Engineered Plans... • ' � � � - � . �
<br /> �� ""**PROPERTY SURVEY required for eII.NEW..construction. , f
<br /> '�'Directioris:l � •,,�..,..� . _. ,
<br /> - Filfoufiapplication completely.
<br /> . - t�rmec'&Cantcactor siga,back af apptication,nofarized =
<br /> ; If ove II$2500,a Notice of Commencement is required. (AIC upgrades over$75qq)
<br /> •*' Agent(fo'rEti'e�cont`ractar)or�Power of Attorriey{fbr'the oumer}would be sameone with notarized letter from owner authorizing same • �
<br /> •-OVER;THE��COUNTER_PERMITTING (copy of contraat requlred) -
<br /> ` Reroqfs if sringles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) � ' `
<br /> Drive��iays-Nat over Counter if an public roac�w�iys::needs`I�'OW"'^'�''•��w•�--- �--� '`i' '"""" �`�""'"`' �' """,'�' "" "°` '"" "� ``
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