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813I780-0020 City of Zephyrhills Permit Application FaX-s�saao-oo2�
<br /> � � • Building Department
<br /> Date Receive
<br /> I Phone Contact for Permitting --
<br /> Owner's Na le ,J��117 S+�� G�y Q/lG �� ���i_�.� Owner Phone fdumber
<br /> -a r} ,Q
<br /> Owner's Address '/ � i/ � Owner Phone Number
<br /> Fee Simple T tleholder Name Owner Phone Number �
<br /> Fee Simple T�tleholder Address
<br /> JOB ADDRESS 3 7�3� � �I(�� LOT# �
<br /> sueoivisio PARCEL ID# lS����'�L �-0�3�—0� 0 0 — D�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e . PVEW CONSTR l..-! ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED SE Q . SFR Q COMM 0 OTHER
<br /> TYPE OF CO STRUCTION Q� BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTIO OF WORK p!-�? ����' � l.0 1�Tr/ 3� �- �-/,�E�rL�SS ,51/Y//���-S
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> QBU LDING $�D �,v� VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> OME HANICAL $ VALUATION OF MECHANICAL INSTALLATION � � l � '
<br /> O G Ai Q� R O O F I N G Q S P E C I A L T Y � O THER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> ELECTRICIAW COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> � Address License# �
<br /> PLUMBER.: . COMPANY
<br /> SIGNATURE REGISTERED Y•/ N FEE CURRE� Y/N
<br /> Address License#
<br /> M ECHANICAI. COM PANY
<br /> SIGNAYURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �' License#
<br /> OTHER� � � COiIAPANY U`�I/U D�G/��
<br /> SIGNATURE-. - � REGISTERED Y/ N FEE CURRE� , Y./N
<br /> Address . � • Q�� ,3 G�i�G l�/"�� License# ��y��
<br /> tiii+hF+lii+H
<br /> - RESIDENTIA�` : Attach(2)Plot Plans;"(2):sets of Building-�Plans;(1)set of Energy Forms;R-O-W Permit for.new.consVucUon,
<br /> : , � Minimum.:ten:(;10)inrorking days after submittal date. 'Required onsite,Cbnstruction Plans,Stbrmwater Plans w/Silt Fence installed,
<br /> Sanita,ry Facilities&1,.dumpster;Site:W,ork Permit for,sutid'ivisionsAarge projects
<br /> .COMMERCIA Attach'(2)complete'sets 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 /> � Sanitary Facilities&1 dumpster.Site Work Permit foc all new projects.All commercial requirements must meet compliance
<br /> -�SIGN'PERMI I Attach(2)sefs of:Engineered Plans. �
<br /> '*"*PROPERTY SURVEY required for.all NEW construction.
<br /> Directions: .��
<br /> Fill out a�plication completely.
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$ 500,a Notice of Corrsmencement is requlred. (AIC upgrades over$7500)
<br /> "" Agent(fo the coritractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> � OVER THE COUNTER-PERMIT7ING (copy of contract required)
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> Drivewa s-Not over Counter if on public roadways.:needs ROW.-. 3r, • � ' '� .., • , . •. , ,r
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