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; I813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • • Building Department
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<br /> Date Rec ived
<br /> � � Phone Contact for Permitting - _
<br /> Owner's fYame /✓ i � � ��"1 � /°[ P�/ �'� Owner Phone Number , �
<br /> � Owner's Address � l J Owner Phone Number
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<br /> " Fee Simp e Titleholder Name Owner Phone Number
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<br /> Fee Simp e Titleholder Address
<br /> � �� JOB ADD�ESS /t't G V LOT#
<br /> SUBDIVISION �/7' �v/�� < C' ' PARCEL ID# D "' -�r-✓��O-�'�� ��b �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED . NEW CONSTR ADD/ALT 0' SIGN Q � Q DEMOLISH
<br /> e INSTALL e �REPAIR
<br /> PROP,OSED USE Q SFR Q COMM 0 OTHER :
<br /> TYPE'.OF ICONS7RUCTION Q BLOCK • Q ,FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK. C. G� D(/ l ��yl /�yJ �/1�� � �
<br /> BUIL"DIN�SIZE SQ FOOTAGE�� HEIGHT •
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<br /> ��BUILDING $
<br /> � VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> � Q,I LUMBING $
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<br /> + �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
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<br /> � Q'GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> � FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N. .
<br /> Addr ss License#
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<br /> 'ELECTRI�IAN , COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> - Aaa�ess License# ' '
<br /> PI.UMBER�., COMPANY-
<br /> 1•3: ..IF' ,
<br /> SIGNATURE `REGISTERED Y/ N " FEE CURRE� � Y/N
<br /> � , Address Cicense#
<br /> � MECHi4Nl��AL� � , COMPANY n� ��i�r � I �n �
<br /> ' SIGNATUf�E'' � REGISTERED ,' Y N , FEE CURRE� , N
<br /> � aaa�fss=� �n � License.# L
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<br /> � _ OTHER�- � " - ' COMPANY
<br /> I ''SIGNATURE•:�;-: ' • � REGISTERED Y/.N. FEE CURREK Y/N
<br /> � Addre'ss� �� . . . :F` • . �- ,� . License#
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<br /> � �>,RESIDENTIAL'.��;'"AttacFi;.(2):PIof�Plan's;='(2):sefs�of�Building•Plans;(1•)'set ofEne�gy.Forin§;R=0-W,Permit,for new.construction,
<br /> : �.�-:-,��::,,.�-•;.Minimum;:ten;;10.working;.clays:after'submittal�ilate:�"Required`onsite;"Constniction Plans,'Storminrater Plaqs w/Silt Fence installed,
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<br /> -.. � � � �Sanitary,;Fac111ties,8��,1;dumpster;�Site�Wor,ic FertniFfor subdivisions/large projects' � • ___
<br /> c.�COMMERCIAL Attach`(2)'complete`sets`of'Building�Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcGon.
<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 PermitTor�all-new p�ojects.All commercial requirements must meet compliance
<br /> '.'`�SIGN;.PERMIT ""Attacti(2)sets of;Engineered;Plans.=+�.�: - �
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<br /> �"-�-�- """PROPERTY SURUEY reguired for all NEW construction.
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<br /> ' �;DiFectioris�l :�-..�.::. � , " _
<br /> '� ,� '".� �FilC:out application.completely. � V
<br /> � � Ovirne�;&Contractor sign back of application,notarized
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<br /> ' ,: If ove�$2500;a Notice:of Commencement is required. (AIC upgrades over$7500) ., : ..„
<br /> , "'"" .Agent(for'4ti'e'cont�actoi')`or�Power'of Attomey(fo�'tti'e owne�)virould'tie someone with notarizedietter from owner authorizing same
<br /> :'„OVER_THEiCOUNTER;PERMITTING. ° � _(copy.of contract�required)� � -`
<br /> ' =Re�oofs if s�iingles Sewers � Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> Drive Irays-Not ove�Counter if on public'roadways..neecJs ROW '
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