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8131aso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> " Building Department
<br /> Date Received �7 � , 2 ^ ��-�_
<br /> il — 1 — � � �Phone Contact for Permitting � ►J /
<br /> �Owner's Namle � � < < S Owner Phone Number
<br /> �Owner's Add ess � • �Z� ��7�`Oil�rner Phone Number
<br /> Fee Simple T tleholder Name Owner Phone Number
<br /> Fee Simple T tleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISIO PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED e '� WSTALLSTR 8 �REPi41R � SIGN Q � DEMOLISH
<br /> PROPOSED USE Q SFR Q COMM Q OTHER
<br /> TYPE:OF CO STRUCTION Q BLOCK •• Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK � � ��1 �-�—�.�
<br /> BUILDING"SIZE SQFOOTAGE� HEIGHT • �
<br /> OBUI�DING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QEI:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> ,�j OPLU BIiVG $ ��� � ��
<br /> v� /
<br /> � G, �
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> Q,GASI Q ROOFING Q SPECIALTY 0 Ol'HER 'Z 21 V
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER • COMPANY
<br /> SIGNATURE REGISTERED Y'/ N FEE CURRE�. Y%N I
<br /> Address License# I
<br /> ELECTRI,GIAN , COMPANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURREI� � Y/N
<br /> Address License# �
<br /> PCUMBER.,., � �'� COMPAfdY�` '
<br /> � . , ....._ �.,l5� � � . c�C��-`c � �1
<br /> SIGNATURE •REGISTERED , Y/'N: FEE CURRE� � Y/N
<br /> , Address Licerise#' �
<br /> ` MECHANICAL' � _ COMPANY
<br /> SIGNATUREx' ' � REGISTERED Y/ N - �: , FEE CURRE� Y•/N
<br /> Ad"tl�ess�'° ' ' � License.#,
<br /> .—.,'4',;�r• .._ � . . .
<br /> ;�.OTHER�� ""` `COMPAWY .
<br /> '`81GNATURE��>;, � .�• � - ' �riE�ISTEReo Y/ .N FEE CURREK Y/N
<br /> i�9`.':1�, ar , . 1.,,. � .. , . ..
<br /> �Address*� _ - _ - � ' ' License# �
<br /> `'�:.. ,.. , . .. . -; -.. .
<br /> %.;:-,RESIDENTIAL;;�� `Attacfi;(2);<Plot'Plan's;'?(2�)�sets'of`Building�Plans;(1�)°set"of�Energy'Forrris R=,0=V11.Fermftfornew.constructlon,, ,
<br /> , �; , � Minimum;ten�(;10)workirlg;days:after subrriittal�8ate.•Requi�e8'onsite;Con`struct�on Plans Stormvirater Plans w/Silt Fence installed,
<br /> - � � `�� ��tSarntary,Facilities,8,-:1,dumpste,r-,Site WorkPermitfor..subdivisionsAarge�p�ojeots� ' = I
<br /> '���:C.OMMERCIAL Attach�(2)�complefe'sets of'Building Plans plu's a Life Safery Page;(1)set of Energy Forms.R-O-W Permitfor new constructlon.
<br /> - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w!Silt Fence installed,
<br /> Sanitary FacilfUes&1 dumpster..Site Work Permit"fo�•all-new projects.All commercial requirements must meet compliance
<br /> ��"-'SIGN:PERMIT "-Attaclir(2jsets�of:,Engineered.Plans:��:. <.•: �
<br /> *""PROPERTY SURVEY,reGuired for.�a11,NEW.construcUon..
<br /> '-;;, . II
<br /> -��Di�ections: :r;:;��•.,..,- ., ..- '
<br /> .�Ftll_out�appllcation completely.
<br /> �O.virner,& �ntraotor sign'back of application,notarized
<br /> '1'f over,$2590;a Notice of Commencement is required. (AIC upgrades over$7500)
<br /> � 'l.Y.::I1.:. :�+�•':
<br /> "'� AgenY(for�e contractor)�orPower of'Attomey(for ttie ovmer)would tie someone with notarized letter from owner authorizing same I
<br /> ';;OVER.THE COUNTER�PERMITTING ..._ .(copy-.of-contract�required) '' "
<br /> 7I _._
<br /> -Reroofs 1f sliingles Sewers = Service Upgrades EVC Fences(PIot/Survey/Footage)
<br /> ..,,., ,
<br /> � — I, -.-",_,�_;1 ' ` r,.,, �
<br /> Drtveways= ot over Counter if on public"roadways..needs ROW
<br /> � , � :.
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