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: s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 �
<br /> ' • Building Department
<br /> Date Rec,�i•rad
<br /> Phone Conta'ct for Permitting` —
<br /> H Owner's Name � � S -f `�w!�' � Owner Phone Number , �
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<br /> I Owner's Address �O � S �/.Q Owner Phone Number
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<br /> Fee Simple Titleholder Name Owner Phone Number
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<br /> � Fee Simple Titleholder Address
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<br /> S JOB ADDRESS LOT# �
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<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED , NEW CONSTR ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> B INSTALL e REPAIR
<br /> PROP,OSED USE. Q SFR Q COMM � OTHER :
<br /> TYPE'.OF CONS7RUCTION Q BLOCK • Q FRAME 0 STEEL Q
<br /> _. - t S �._ . `�,u� ` � ` . . . .
<br /> DESCRIPTION OF WORK � l �
<br /> BUIL"DING SIZE SQ FOOTAGE� HEIGHT :
<br /> QBUILDING $ 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 /> , QMECHANICAL $ �� VALUATION OF MECHANICAL INSTALLATION _ �
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<br />,I i QGAS Q ROOFING Q SPECIALTY � OTHER
<br />� f FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
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<br /> I i BUILDER COMPANY
<br /> F SIGNATURE REGISTERED Y�/ N FEE CURRE� Y 1 N
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<br /> � Address �License#
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<br /> 'ELECTRICI. - COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# , 9
<br /> � P.LUMBER.,,,, . COMPANY,
<br /> I SIGNATURE REGISTERED Y./ N FEE CURRE� Y/N
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<br /> iAddress . License#'
<br /> ( MECHANICAL' COM.P.ANY _ /�' Q ��Q
<br /> I SIGNATURE� � REGISTERED , Y/ FEE CURFtE� , Y/N
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<br /> � Add"r`ess�• - � � " License.#
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<br /> � , OTHER=� `� �� � ' COMPANY
<br /> I �`'SIGNATCIRE;�:;.-:_ �_ - - REGISTERED :Y/.N . FEE CURREK Y/N
<br /> *'r::i' . . _ + _., � . , ,
<br /> , Address�. .:t � ���F;. ' � � �� - ' Lioense#
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<br /> �"RESIDENTIAL��;: `;Attach,:(2):Plot"P.lans;!�2):sefs�of;Buildin,g�Plans;(1°)�setof�Ene�gy.Foriris;�R=A-W,Pe..rmit,fornew.construction,.
<br /> ;� �.;'X�s__���:_,�=�..,Minimum+,ten!(;10)wo�king;iiays':aftersutimittal�date:'Required'ansite;�Constniction Plans,Stormwater Pians w/Silt Fence installed, �
<br /> - - � 3anitary°,Faciflties;&��,1�:dumpster;.Sife;Wor,k F.emiitfor..subdivisions/large'proJects'_ " I
<br /> _ �"�;COMMERCIAL AttacH°(2pcomplete�sefs'of'Builtling Plans plus a`Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. I
<br /> ' Mlnimum ten(10)wo�king days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt F.ence installed, �
<br /> r;,``�• Sanitary Facil(tles&1 dumpster..Site Work.Permit foF all-new p�ojects.All commercial requirements must meet compliance
<br /> �,;SIGN PERMIT "Attach`(2)setsvof;Engineered�Flans.��� �< ` =..
<br /> ' �' - "'*PROPERTI'SURVEY requlred fot.all,NEW..construcUon.-
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<br /> j `��r�Directioris: ._--�:�....� , •« � _ ,
<br /> � � '",� F(IU:out appiication completely.
<br /> � ` �O,wner`&ConVaotor sign.6ack of application,notarized
<br /> �If,over$2500;a Notice�of�Commencement is requlred. (AIC upgrades over$7500) ,
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<br /> � ,�:'"' .i4gent�(for tfi'e'contFaotor)�or'Power of Attomey(for'tFi'e oinrne�)would tie someone with notarized letter from owner authorizing same
<br /> ' �;:OVER�.THE COUNTER'PERMIT�TING,.. ,. .(copy_of•contract-required)��' " ' � `�
<br /> � :s;Be�oofs�if sFiingles Sewers Serv(ce Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> � _ Driveways-Not over Counter If orr publio ioadways.:needs ROW
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