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' 0813-780:002o City of Zephyrhills Permit Application Fax-813-780-0021 ,
<br /> � ' ' Building Department \_ �.-
<br /> Date Received , , phone Contact for Permittin � — �3
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<br /> , Owner's Mame ���US ��(G� Owner Phone Number , p�3' •�j� (r�0
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<br /> ± Owner's Address � 3� S'E"� r�.�€, Owiner Phone Number I
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<br /> ? Fee Simple Titleholder Name Owner Phone Number
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<br /> � Fee Simple Titleholder Address� , ,,
<br /> jJOB ADDRESS � ��h � LOT# I Z
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<br /> � SUBDIVISION C `V ,Z. � PARCEI:ID# 1` ' 2 to ' Z. • OO • � .S- - ' a
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED , NEW CONSTR ADD/ALT �� SIGN Q � Q DEMOLISH
<br /> B INSTALL B REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM Q OTHER :
<br /> TYPE`.OF CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK a ���1 �, �.
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •.
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<br /> �BUILDING , $ � � VALUATION°OF'TOTAL CONSTRIJCTION _
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<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
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<br /> QPLUMBING $ '
<br /> ! QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � �CJ `""
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<br /> s QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> ; FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
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<br /> � BUILDEPt � � � COMPAIdY �SfOQ�
<br /> SIGNATURE � � REGISTERED Y'/ N FEE CURRE� Y/N
<br /> � Address �13� w. -License# L 5 U �
<br /> ; 'ELECi'R�CIAN �..- COMPANY
<br /> .. SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Address - License# - � r
<br /> PI:UMBER.; , COMPANY I
<br /> SIGNATURE REGISTERED Y.•/ N: FEE CURRE� Y/N
<br /> � Address Licerise#
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<br /> I .,' MECHANICAL , COWIPANY _ I
<br /> � SIGNATURE'' � � REGISTERED Y/ N FEE CURREh , . Y/N II
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<br /> jAdd�ess���� ' ' - ' l:icense.#
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<br /> 1 OTHER�r ...- : " • ' ' COMPANY
<br /> I .' SIGNAT.l1RE':ia,�:� •� - _ � � REGISTERED _Y I.N � FEE CURREK Y/N ,
<br /> ± aaa����.:- �+�•:: :a� - - ' � . ' �License#
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<br /> '':`RESID�NTIAL��•�: ;Attach;(2):Plot�:Plans;`'(2-):s'efs�of�Buiidirig��Plans;(1)'set of�Ene�gy:Forins;R;0=1N Perriiit,for new.construction,:�� -
<br /> ,:�«'g����-��� •�m Minimum;�ten�(,1Q).yworking�days'`afte�suti'mittal:date:"Requi'red~onsite;Gon`struction Plans,`Stormvirater'Plans w/Silt Fence installed,
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<br /> :^�. - �c,.°.:.*;.^-.,,._. ., . .,-� ,- . . - •
<br /> �-�-. Sanita;;,Facilities,&�t,.dum ster;_„S,ife:Wock:P.ermit,for:subd'ivisions/lar e: ro'ect§-- ' ' " �
<br /> -::,,:�- :.. .;,,,�Y _::� :.:.�.,",..,.,, ...p r,. Ar., �.,,.;:. . .: :.._,.... .. ....._ .. 9 P .1_ . .
<br /> _ _.u:cCOMMERCIAL Attaoh'�(2)�complete'sets of'Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permitfor new construction.
<br /> = ; Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> - Sanitary Facitities&1 dumpster._Site Work Permit:foF all-new p�ojects.All commercial requirements must meet compliance
<br /> i��;�SIGN;PERMIT ""Attacti'"(2)sets;;of;Engineered�,P.lans.��- �.: -: � . �
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<br /> s=:",'"�` - "."""PROpERTY SU�VEY reguired,for,;aII,NEW.construction:.
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<br /> � L�E,Dfrectiqns: ,<.g•3iF,_ . > , .,. . - _ -
<br /> � � A Fill-:out appliaation completely. +
<br /> , � Owner 8 Contractorsign.back ofapplication,notarized
<br /> � � If over$2500;a Notice�of Commencement Is requived. (A/C upgrades over$7500) ; ,_ _ _
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<br /> �"'"" Agent(for{he�cont�actorpor�Power of Attomey(for`tFie ov+mer)would'be'someone with notarized letter from owner authorizing same
<br /> ;�;OVER:THE�COUNTER`PERMITTING'.'"..':.`�::(copy_of-contrac't�required) '` `-` - " �
<br /> i ,::=Re�oofs if sfiingles Sewers ;,Se�rvice.Upgrades A/C,� .Fences(PIoUSurvey/Footage)
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<br /> : �'DFivewrays-Not over Counter if�on_public roadways..needs ROW�
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