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<br /> s�s-Tso-oo2o City of Zephyrhills Permit Application Fa�c-813-780-0021
<br /> a Building Department
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<br /> Date Rece(ve�l �Phone Contact for Permitting ' --
<br /> Owner's Namb j /Z �L sC�G h�� /C Owner Phone Number
<br /> Owner's Addross Owner Phone Number
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<br /> Fee Simple Til leholder Name Owner Phone Number
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<br /> Fee Simple Tii leholder Address
<br /> JOB ADDRESS �5 vzZ- � ��T�-- �L U � LOT# �
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<br /> � SUBDIVISION� PARCEL.ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED .. NEW CONSTR' ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> I e INSTALI B REPAIR
<br /> PROP,.OSED USE Q - SFR � COMM Q OTHER
<br /> TYPE:OF CORISTRUCTION Q BLOCK •- Q FRAME 0. STEEL Q
<br /> DESCRIPTION OF WORK � �� � S��� _ l✓-� ! �^ �Z�I 1 I S !/t� S �,
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT ,
<br /> QsUILDING $ VALUATION'�OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING $ , � f �T���
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<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
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<br /> Q,GA i Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
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<br /> -BUILDER � � COMPANY ����2� %�x S��V f G�
<br /> SIGNATURE REGISTERED Y'/ N FEE CURREt� Y 7 N
<br /> Address Llcense.#
<br /> �ELECTRICIAN . COMPANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Address� - License# '�
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<br /> PCUMBER.; . . COMPANY -
<br /> SIGNAi'URE� •REGISTERED Y•/�N. � FEE CURRE� � Y/N
<br /> , Address Licerise#`
<br /> ' MECHANICAL' ' � � COMPANY �
<br /> ` SIGNATURE`" '� � � REGISTERED , Y,/ N FEE.CURREA Y/N
<br /> Adii�ess: - "- License.#
<br /> "�i:,�.,.,. :
<br /> , _OTHER:: �:'': . COMPANY
<br /> "'SIGNATURE�,; :� .• - - - � REGISTERED Y/.N. FEE CURREK Y/N
<br /> _ Aaa��s� - �; � � ' License�#
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<br /> ��' ``rs;..<< - � . .
<br /> ��;.RESIDENTIAL^:;'�Attacfi4(2)':PIot�Plans;'(2-)':sefs�ofBuilding�Plari's;(1�)°set of�Ene�gy;Forms;R;O=W Pemift,for new.construction,
<br /> �-��t,f-������ ��-.Minimum�•ten�(,10).working��day`s''afte��"sutimittal•dafe.�-Requ'i�ed onsite;Construction Plans,Stormovater Plans w/Silt Fence.installed,
<br /> :. _ :c;-�.:.°y=' -. .. � .: . ,
<br /> ;:ti� i Sanitary,�,Facilitiest&,•1�;dumpster;�Site,Wor.lcPermitfor:subdivisions/large',proJe.cts� �" 'r ' � �
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<br /> ;�.:.C.OMMERCIAL Attach�(2)`complete'sets of Building"Plans plus a Life Safety Page;(1)set of Energy Fortns.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 Facilitles 8 1 dumpster.,Site Work Permit fo��all new projects.All commercial requirements must meet compliance
<br /> ���:SIGN:PERMIT� "Attaah(2)sets;of-,Engineered P_lans:��� _•; . �
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<br /> "'`:= � '•"'PROPERTY SURVEY required for.all.NEW constructfon.-
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<br /> ;`�;Di�ectlons: ._:.>;:-, .:, ., .
<br /> .- `` �Filf:out application completely.^,
<br /> . _ Ovime�`&�Contractor sign back of appllcation,nota�ized
<br /> 7f over$2500;a Notice�of:Commencement is required. (AlC upgrades over$7500)
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<br /> ."'" AgenY(foq the°cont�actorpor°Power'of'Attomey'(for tlie owner)would be someone with notarized letter from owner authorizing same
<br /> i'`,;OVER�;THE;COUNTERuPERMITTING, ._ (copy_of contract required)
<br /> �:=;Re�oofs.if shfngles Sewers Servlce Upgrades A/C Fences(PIoUSurvey/Footage)
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<br /> DrlVeway's-Not over Counter if on pu6lic roaduiiays..n'eeds ROW
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