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<br /> a�s 7so-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> - Building Department
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<br /> Date Receiveld Phone Contact for Permltting —
<br /> Owner's Na Ile /�' �� �,(l�f/G� Owner Phone Number
<br /> Owner'sAdd'ess �3 � �3 �� S� OwnerPhoneNumber
<br /> �
<br /> Fee Slmple�tleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRE�S �3 3� Z� RD s/ ' LOT# �
<br /> � SUBDIVISION PARCEL ID# �� � �- � a��'a dOS�� ���a
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED .. NEW.CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> e INSTALL e REPAIR
<br /> PROP,OSED I SE � Q SFR Q COMM 0 OTHER
<br /> TYPE'.OF CO STRUCTION Q BLOCK -• Q FRAME 0 STEEL Q
<br /> DESCRIPTIO OF WORK � S/��� L���-
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<br /> BUILDING SI�E SQ FOOTAGE� HEIGHT •
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<br /> QBU LDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> EL�CTRICAL $ AMP SERVICE PROGRESS ENERGY W.R.E.C.
<br /> 0 II 0 �
<br /> .. L� MBING $ /SO� � ��
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<br /> OM CHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
<br /> Q,G.S Q ROOFING Q SPECIALTY Q OTHER ���
<br /> FINISHED F�OOR ELEVATIONS FLOOD ZONE AREA DYES NO
<br /> BUILDER COMPANY �
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE�. Y/N
<br /> Addres� License#
<br /> "'ELECTRI,CI. COM PANY
<br /> .-SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> � Addres � - License# � "
<br /> _ ,.c�,. ' .S.E�N/G� ��li� ..jst�
<br /> PCUMBER.;, COMPANY- . ��.l,s
<br /> -'SIGNATURE. REGISTERED , Y/'N FEE CURRE� � � Y/N
<br /> Addres ��SZ �'S 3�� �� ��9 dF G 1� r� -License# : � �S'�]��/
<br /> � MECHANIC��'' ` COMPANY
<br /> SIGNATUREi � REGISTERED ; Y/ N , FEE CURRE� , Y/N
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<br /> Ad'ilres =�' I:icense.#
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<br /> ,.,.OTHER�� °` ' " COMPANY
<br /> '�`'SIGNATUR_ :;,�, .• _ - - ' REGISTERED Y/.N_ FEE CURREK Y/N
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<br /> . Aaa�es - ., � �i��se#
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<br /> �-RESIDENTI ;::;';Attacfi;(2)':Plot'P.lans;;(2)�sefs�of�Buildirig Plans;'(1•)�setof�EnergyForriis;R=,O=W Permitfornew.construction,.
<br /> _ 4..�3,`;�,,;`:;Minimum:ten�(�10);wqrking;days;aftec�submittal•ilate.,Requi�ed onsite;'Constructlon Plans,`Stormu"vater Plans w/Silt Fence installed,
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<br /> ���= "`� � �� ��Sarntary..;Facilibes 8��11dumpster;_Site:,Wor,k Permit-for.,sutidivisions/large.p'rojects �
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<br /> =:�:COMMERCIAL Attacti��(2)`complefe`sets'of Buildirig Plan§�plu's 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 FaciliUes'&'1 dumpster.Site Work Permit"fo�all-new projects.All commercial requirements must meet compliance
<br /> -:<SIGN-PERM T ""'Atfaoh(2)sets;:of;Engineered;Plansa,� .. ��
<br /> �R1IRPROPERT-Y SURVEY[equired for,.aII.NEW construcUon.-
<br /> �`=,Direotions: I =,:.;:i•�, ... ..
<br /> - - :.� �Eill out�pplication completely.�P��
<br /> . �Owner.�Contra�tor sign back of application,notarized
<br /> 'If:over�2500;a Notice of Commencement is required. (A/C upgrades over$7500)
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<br /> +�"'� Agent("rth'e•cont�actorporRower of Attomey'(for'tli'e owner)would be someone with notarized letter from owner authorizing same
<br /> �`:'OVER T,HE'COUNTER;,,,P�ERMITTING> _-. _(copy.of.contract required) ' `" �
<br /> �_:�R'e�oofs.if:sfi�ngles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drtvewllys-Not overCounter if on public roadways..rieeds ROW �
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