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! 81i3-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � - • Buildfng Department
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<br /> Date Received �, 5�y 3 � 3�
<br /> p � Phone Contact for Permltting
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<br /> Owner's Name �C� �� Owner Phone Number , ��3� �"3 9 3 �
<br /> 4 Owner's Address ���+'� �- Sa J�'` �J� Owner Phone Number
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<br /> f Fee Simple Titleholder Name Owner Phone Number
<br />' � Fee Simple Titleholder Address �
<br /> � JOB ADDR�SS 3�SC0�2- Sov-� �v-� � h l��'1 i �IS FC � �
<br /> LOT#
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<br /> SUBDIVISION PARCEL ID#
<br /> , i (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED . NEW CONSTR ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> B' INSTALL REPAIR
<br /> • PROP.OSED USE• Q ` SFR Q COMM Q OTHER :
<br /> TYPE':OF CONSTRUCTION Q BLOCK • Q FRAME Q STEEL Q -
<br /> DESCRIPTION OF WORK �i�'i v�c T F-�h« ( /O y -��-, /�„ x (,.�}- �, ��L, W t;oci� )� y 0 U
<br /> BUILDING�SIZE SQ FOOTAGE�� HEIGHT •
<br /> Q i UILDING $ f , � VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING $
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<br /> ; QMECFiANICAL $ VALUATION OF MECHANICAL INSTALLATION I�
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<br /> i Q,GAS Q ROOFING Q SPECIALTY 0 OTHER ��'�i� 1
<br /> 4 FINISHED�FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> � BUILDER� ���� � COMPANY
<br /> � SIGPIATURE REGISTERED Y'/ N' FEE CURRE� Y/N. :
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<br /> Addrll ss -License#
<br /> ELECTRICIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N � FEE CURRE� Y/N.
<br /> address - u��se# " °
<br /> PtUMBE�.,. COMPANY '
<br /> SIGNi4TURE REGISTERED , Y•/'N. _ FEE CURRE� � Y/N
<br /> . Address License#
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<br /> ,' MECHANICAC COMPANY
<br /> SIGNATURE� �' � REGISTERED Y/ N FEE CURRE� , . Y/N
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<br /> � Add�ess� � - � License.#
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<br /> I `, OTHER<t..,','�, ; �� C,OM,PANY
<br /> `�`SIGNATURE��=~1:>� . - � •. '� . REcisTEReo Y/_N.. FEE CURt�n' . Y/N
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<br /> Address�_• - � ��_ - Licen'se#
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<br /> �"`-'.RESIDENTIAL�:^,�_. `�;Attacli;(2):PIof;Plans;�(2)'set's•of�Building•Plans;(1�j`set of�Ene�gy'Fomis;R=,O-VU Perr'i%it.for new.constivction,
<br /> � w.>.r�.�,��:�-���`:Minimum;ten,(;10.).working,.day"s;aftersubmittal�ii`ate."Requireii�onsite;'Gon`struction Plans;Sformwater Plans w/Silt Fence installed,
<br /> ;:' �,:..„-i_;,..:,,:,:,....��.,,.�. .. ...... . ..... , ,
<br /> ;�-:.,. _ Sanita,rytEacllities�8��;Y1��dumpster;Sife�Wor,k Rermit for:subdivisions/large'p�ojects:` ' ' - - •
<br /> ;�COMMERCIAL Attacfi�t2)'complete�sets of'Building'Plans plus a L'ife Safety Page;(1)set of Energy Fortns.R-O-W Permitfornew construction.
<br /> '� ' - Minimum ten(10)working days after submittal date. Required onsite,ConsUvction Plans,Stormwater Plans w/Silt Fence installed,
<br /> , �;'.._,_ -� Sanitary Facilities 8�1 dumpster.Site Work Permit fo�all-new p�ojects.All commercial requirements must meet compliance
<br /> I ;�:;:$IGN°.P..E IMIT "Attach°(2)sets;of;Engineered,Plans:��� ,r: ' '
<br /> f ;�`:-�:�° "`""PROPERTY SURNEY required for,.aII,NEW.construction..
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<br /> � .;:;�;Dl�ectlons: :�-.���.:_�;. .... ,. --
<br /> " FIIP:out application completely. ,
<br /> � `Owner"&Contra�torsign:back of application,notarized
<br /> ;"*. ,If oveIr$25004 a�Notice.ofCommencement is required. (AIC upgrades over$T500) _, , _
<br /> , Agent�(for`4h'e�contractor)'or�Powerof`Attomey(for'tlie�owner)would tie someone with notarized letter from owner authorizing same
<br /> ��;`�OVER�.THECOUNTER�PERMITT;ING., (copy,of-contract�required)�-"� ` � -' -
<br /> ' `'�.�Reioofs if sfifngles Sewers Service Upgrades A/C Fences(Flot/Survey/Footage)
<br /> � Drlveways-Not over Counter if on public�roaiiways..neeiis R01N '
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