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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � , ' . Building Department
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<br /> Date Received f� /� ��• Phone Contact for Permitting • � / ( �� — ��
<br /> Owner's Nami 6�1� n. Owner Phone Number �>(�J E�T
<br /> Owner's Address � J � �`� a Owner Phone Number
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<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � � � � v�C LOT# �
<br /> SUBDIVISIO PARCEL ID# � "— '�� �'� 77��'""�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROP,OSED e NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> � INSl'ALL •REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q�OTHER . c ' D vlQ1`
<br /> TYPE'OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q
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<br /> DESCRIPTIO OF WORK (' . 4 ' � �� � �S�
<br /> BUILDING SI I E ,f7OO .j SQ FOOTAGE ��l� HEIGHT F�J y •
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<br /> BU�LDING $ �.���Q �� VALUATION OF TOTAL CONSTRUCTION
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<br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �� � �� �
<br /> 4
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> QGA� Q ROOFING SPECIALTY OTHER
<br /> FINISHED FLIOOR ELEVATIONS � FLOOD ZONE A�REA QYES NO
<br /> BUILDER I � /�j/ �COMPANY
<br /> SIGNATURE �Y REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � �� � ' r/'2.- �License# � I
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ticense# ' I
<br /> PLUMBER, , COMPANY �
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address � License#-
<br /> MECHANIC COMPANY
<br /> ' SIGNATURE' ' REGISTERED Y/,N FEE CURRE� Y/N
<br /> AddFe'ss- . License#�
<br /> OTHER+� � COMP..ANY I I
<br /> SIGNATURE � ' � REGISTERED. , Y/N.. FEE CURRE�' ,, .Y/N
<br /> Address � � - - License#
<br />__;_.RESIDENTIAL -� Attach(2).PlofRlans;.'(2)sets of�Building-Plans;'(1�)set of EnergyFo,rms;'R=0-W Perrriit.for new construction,
<br /> ,ti,� ...;I._..` Minimum�ten;(.10)working:days after.§ubmittal'date. Required'onsite;Construction Plans,Stormwater Plans w/Silt Fence installed, -
<br /> � Sanita,ry,FaciliGes:,&;1.dumpste[;Site..Work�Permit foe subdivisions/large projects
<br /> �-.COMMERCIAL Attaeh'(2)�'complete sets of Building Plans�plus a Life Safety Page;(1)set of Ene�gy Forms.R-O-W Permif for new construcUon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> San(tary Facilities&1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance
<br /> � SIGN PERMIiI Attach(2)sets of,Engineered Plans.,
<br /> '"'*PROPERTY SURVEY requi[ed for.aII.NEW construction.
<br /> Dlrections: il E, . _.,...._._. �.. : ._.:<. _�.r.._. ...> . . ... , - _.."1;:'; ;.,'i;� .!:., ,.:�... },.
<br /> Filloutapplicationcompletely. •':� .._:i� ... .,,;�_^t)�'..:s��-s�"� �, r;;,�:,�.;,p�..R�„ .,..i,�.. ,.. _�
<br /> . OwnerB�IContractor sign.back of application,nota�iieii:� .....-ei;n^o:!_ - ' .; ;�•;�_, r,,r;;...,; :..�, ' ,�� �s;
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<br /> If over$2500,a Notice of Commencement7sirequired:v(A/C•r�pgrades�ove�;$7500) « e;t•�-:�:,,' ..- �_� ..� .,.s�.,�r�,s'��=• ,,,..,. ''
<br /> �.:�'- •? '('f.1;,: :.':.�r.a r'� F�,._�:.-,v�...�,
<br /> �� i i i iq';v:�;j,,;ri.`.�i2c'�, `':' , ,. ".' -.... ,.. . ,..- ..�Re.._.
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<br /> Agent(f II We contractor)or Power of Attome"(for tFie owrier)woulii;be,someone with notarized letter from owner autFiorizing same~
<br /> < . ,._.���, .�_.,.w,..,._ ,�._ . .
<br /> OVER THE COUNTER PERMITTING �(copy of contract required)
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<br /> Reroofs if shiigles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drlvewa s-Not over Counter if on public roadways..needs ROW
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