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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ' Bu(Iding Departrnent
<br /> Date Received '= (f'j/ , phone Confact for�Permlttin � � �� — �
<br /> Owner'a Name T1z' �5�� o�c f.C.t pWner Phone Number �f 3 ��', t -�/o
<br /> Owner's Address ��/ � �r �� ` -Owner Phone Number
<br /> Fee Simple Tltleholder Name � —� Owner Phone Number
<br /> ,r � •
<br /> Fee Simple Titleholder Addresa
<br /> JOB ADDRESS ��� � J 6'(�c S� t� r �S LOT# �
<br /> SUBDIVISION � PARCEL ID# �
<br /> (OBTAINED FROM PROPERTY.TAX NOTICE)
<br /> WORK PROPOSED � NEw CONSTR ADD/ALT Q SIGN` 'Q � �Q DEMOLISH
<br /> . INSTALL 8 �• REPAIR �
<br /> PROPOSED:USE . Q SFR Q �COMM Q OTHER
<br /> TYPE OF CON3TRtJCTION" Q ' BLOCK ' Q FRAME � STEEC Q
<br /> DESCRIP710N OF WORK C7p-�r `� �
<br /> BUILDING SIZE � • SQ FOOTAGE I�� . HEIGHT�
<br /> QBUILDING $ ` --1 J _ ar�� VALUATION OF TOTAL�CONSTRUCTION �
<br /> 1 l.e
<br /> QEL'ECTRICAL •$ " AMP SERVICE Q PROGRESS ENERGY [] W.R.E.C.
<br /> QPLUMBING $ ' -
<br /> - � . � l���9 -
<br /> QMECHANICAL $ ' VALUATION OF iVIECHANICAL INSTALLATION \��
<br /> [�GAS Q ROOFING Q SPECIALTY � OTHER (-1,���...� ��Ls'�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO D � �
<br /> _ - _ ,
<br /> BUILDER - --.- � �COMPi41V1f=• l,���'t S-�. �� I�To�I�r. �;J'C.,)O ��(,•.�
<br /> SIGNATUFYH REGISTERED Y/ N FEE C RREK Y/N
<br /> Address ��� I,��ri,pt �� V t r�•��-l'9�� . �;'�� � L°'icense:# C G(�%_ � �C� .
<br /> .. � �� . � ... -
<br /> ELECTRICIAN, .,,COMPANY:` . ' � ,-, , �
<br /> SIGNATURE � REGISTERED Y/ N FEE 6URRE� ' Y/N
<br /> Address - "' _. License#: , . '.
<br /> PLUMBER ' ' COMP.ANY �
<br /> SIGNATURE' � , REGISTERED Y/..Nc ': ; ^:FEECURREA, Y•/N. '-',
<br /> Address � ' ` .License.# ' , - . � � �
<br /> MECHANICAL � � � � COMPANY . , ..
<br /> SIGNATURE - ' ' � � REGIS7ERED Y,/-N . FEE CURRE� - -. Y/,N:
<br /> Addreas - -� ' � �- � � Ucense#
<br /> OTHER - � . � . � °,- , . . .
<br /> `,'COMPANY,
<br /> SIGNATURE , _ - . � • ' ' REGISTERED - ' Y/ N._: ,FEe cuw�e� ' Y/N
<br /> J
<br /> Address , . - � , .Gcense#• CC L'. I � Q�� �
<br /> RESIDENTIAL:;=� Attacfi'(2),PIot;P.,lans;:(2)sets�of:Buil'dfng�Plans;(1)set of Energy:Foiins;°R-O-VV Permit fo�new construcUon, '
<br /> � . :Minimum ten�(:10);workirlg;days after'submiftal date. 'Required onsite;:Constiucdon-Plans'StormwateF'Plans w/S(It Fence installed,
<br /> -- - � SanlQery Facilltles�&:1;.dnmpsterSite Work�P.;ermit fo[.subdiWsionsAerge=proJebts: _, • '
<br /> COMMERCIAL Attach(3)�oomplete sets�of B'uilding Plens plus a Life`$afety Page;(1)set of Energy Forms.R-O-W Pennit for new construcUon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,CQnstruc8on Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all new:proJecfs..All commercial requlrements_must meet compliance °
<br /> SIGN PERMIT AttacFi(2)"sets of Engl,'neered-Plans.: -.-�,i , . '� . � - �
<br /> "•'PROPERTY SURVEY reguired:for ap NEW_con.struction..
<br /> Dlrectlons: • �•�..` -, .
<br /> Fill out applicaUon completely.
<br /> Owner 8 Contractor sign back of applfcaUon,notarized
<br /> If over a2500,a Notice of Commencement ls requlred. (AIC upgrades over ST500) ,
<br /> " Agent(for the contractor)or Power of Attomey jfor tFie owner)�would be someone with notarized letter irom owner authodzing same
<br /> DVER THE COUNTER PERMITTING- •- .•(Front of-Applicatlon�Only) ' �
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drivewaya-Not over Counter,if•on�public�roadways:.needs ROWi=�_••��--��
<br /> J��� �..--:.,?i,^,..,=?..'={S_i:.`i '�
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<br /> �i."ro.+.�.. . . ..a..r. _a :..._- . •sa . _.`-S'i ..l
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