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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Departrnent
<br /> Date Ftecelved Phone:Contaict�for�Permlttfn O�� ��2 — d�.��
<br /> Owner's Name ! �J ��"r e�C� Owreer Phone Number �!�'
<br /> Owner's Address c��l� " Owner Phone Number
<br /> Fee Simple Titleholder Name � l Owner Phone Nu"mber �—
<br /> �, .t " -
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � � a�� �J'R� ��� LOT# ��]
<br /> SUBDIVISION � ' PARCEL ID� /� � �/ � � ,� C/
<br /> , ' . (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED _NEW CONSTR ADD/ALT Q SIGN` Q Q DEMOCISH
<br /> � INSTALL -�.REPi�IR
<br /> PROPOSED=USE � Q SFR Q COMM `Q OTHER
<br /> TYPE OF CONSTRUCTION � Q 'BLOCK ' Q FRAME Q STEEL" Q
<br /> DESCRIiaTION OF WORK' - . �P..��v� � li Gi e—l.SLQ-% ��I'� !.O/� � l�d7'Yl d��i�
<br /> BUILDINGSIZE � SGl FOOTI�GE " HEIGHT��
<br /> QBUILDING $ VALUATION'OF�TOTAL CONSTRUCTION ,
<br /> QEL'ECTRICAL $ " " AMP SERVICE Q PROGRESS ENERGY Q "W:R.E.C.
<br /> OPLUMBING: � :$ _, ' � � \ .
<br /> QMECHANICAL $ VALUATION OF'fyIECHANICAL IfVSTALLATION l� ,
<br /> _ �l � .. �
<br /> QGAS Q RO.OFING .Q SPECIALTY Q OTHER -
<br /> FIWISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> - " „
<br /> BUILDER COMPi4NY'• �
<br /> SIGNATURE REGISTERED Y/ N FEE cuR�n � Y/N' .
<br /> Address -_ °�� � Ctcense#" �
<br /> ELECTRICIAPI. , - -t COMPANY= -�` ."` 'r _ � - - ,: -
<br /> SIGNi�TURE � REGISTERED Y/ N FEE GORREK°-� '��� Y/N
<br /> . ,. ,. - : _ . . - .
<br /> /�dP63S . ` a� ,, L�CQ�I38,#; '
<br /> PLUMBER �_ � COMPANY ' - ��� �� - -�.
<br /> SIGNA7URE` `�' ; REGIS.TERED Y,../,.N.� ±_,.�, EEECURREN � ,-�� `, Y/.N, ',�:�<
<br /> Address Llcense;#.�l� . , -�,�-, � -- „ �: .
<br /> MECHANICi4L ' , � • COIYIPANY � �}"1�/e�S ;,..A�I�G � "t:.. C
<br /> SIGNATURE ~ REG�S7ErtED Y/-N . " FEE CURREA-F Y:LrtN- : .
<br /> Address -'� 7T'�� ��L°l�'/Ct� ��/7/�6 ��71 ;License#� (..d/Tl�l�.T� .C3.
<br /> OTHER ' ' . ` ' "COMPANY _ � - , � . ..
<br /> SIGNp►TURE , =��' ., `-: 4, � �� � :`. � ° ` _ - � . REGISTERE� Y/ N.._.' " '�FEE CURRE� , Y/N -
<br /> .�. ,
<br /> Addreas' . . ' ��„ � � , . , , - - ` Liaense#� �
<br /> �� ' �'-,�,a'-' :: D� ,.,; ��,...a,..,;,.� :�_. . .:,, ,,. - -�
<br /> �RESIDENTIAL'_;;.="Attaofi`(2):Plot?Plans;(2)sefs..of'BuilBi'ng!Plan's;•(.1)set�of'En'ergy'Forrns;-R=OOW�Perrriltfor'new construction, .
<br /> . :, ktl,Mi.nimum:.ten,(:10),working,days_:efte_r.�submiftal daEe.:s:Requlreii on'site;:ConstrucUon:Plans•,>Stormwate�'Plan�w/Silt'Fence fnstalled,
<br /> � Sanita'ry.Eacpttles;8��.1,,,dumpster;Site Work.Permitfor:subdiv.isionsAarge proJects,:.^p..::. ' " � '
<br /> COMMERCIAL Attach(3)complete sets of Building Plaris plus a Life Safefy Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)warking days after submittal date. Required onsite,ConstrucUon Pians,Stormwater Plans w/Silt Fence installed, -
<br /> Sanitary Facilities 8�'I dumpster.Site NVork Perrriit for all new:projects..All commercial requlrements_must meet compilance `�
<br /> SIGN PERMIT Attach"(2J sets'of Engineered�Plans:�. - '�� , ;� �� , ,
<br /> ••'"PROPERTY SURVEY required for all,NEW construction. .
<br /> Directlons: � �- ' " � '
<br /> Fill out applicatlon completely. - _
<br /> Owner 8 Contractor sign back of applfcatlon,notarized
<br /> If over 52500,a Notice of Commencement is�requlred. (AlC upgrade�over�7500)
<br /> '• Agent(for the contract��; o"" of;Att ,; r e qwn r) ou1d be�someone with notarized�ette�rfr.q.R�,g�r a,�u,t�o in same
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<br /> DVER THE COUNTER PEii�411TTiNG{r`'Fa,;`(F�`o�if`of<ApplicatiomOnly), � ` ,� "��
<br /> Reraofsifshingles Se rsr�'•'uf"�?�Seivice�Wpgrades�fA/C�,:� R �e" -.�`�q�f:2 �.;i'i��_+ s -,>r`i�,����;,; ,�
<br /> ,_� : ;Kences(Plot/Survey/Footage) . , r.:;;t �
<br /> ����_ �r�':\!7��i,�.t� t11F:,i1.3'�Pl�yiq.:.`q l�i�'r`i !� :��:, 1
<br /> !i�,.7-3u::r ,iz;;;,;;t.�r�3 t��l,+ ,�.''r k,
<br /> Drivewaya-Not over Co�unt�'�if�on''p�iblPc�roadways.needs'ftOVV''�, `�' `•t '� �'��r�'����1{���- =�}� _ .�
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<br /> ��` 4(S� .c:i"dju.¢°°:?:'�..._ � �. '`N`�'����'l.�'°y}MZT 4i y� �.�
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