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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> °- Building Department
<br /> .�
<br /> V'r-'
<br /> Date Received J
<br /> - Phone Contact for Permitting-, --
<br /> Owner's(Name C o n n��e C�Tp �1 Owner Phone Number 8����S' l $l'�
<br /> Owner'sAddress . �� /p�� �;����,✓�(� �, � �ch� ZS
<br /> � S4 •. Owner Phone Number
<br /> Fee Simple Titleholder Nam� Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��7�� � .� (�� n � � �- I (�: l. ��S�( LOT# � I
<br /> II
<br />� SUBDIVISION � ��C• �l8 v✓ PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B ,. NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH
<br /> INSTALL REPi41R
<br /> � PROP.,OSED USE � SFR COMM OTHER
<br /> � � 0
<br /> TYPE`OF CONSTRUCTION Q BLOCK •- Q FRAME 0 STEEL Q -
<br /> DESCRIPTION OF WORK U`� � � C.� ���D�I
<br /> .
<br /> BUILDING'SIZE S� - �� 1.9 ��O SQ FOOTAGE l�9'� HEIGHT . l� a
<br /> .,.,.-.��
<br /> OBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ �
<br /> . � 2
<br /> • MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� L
<br /> QGAS Q ROOFING Q SPECIALTY� � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QXES NO
<br /> � '. .
<br /> BUILDER '- COMPANY -�- �S l7'���_ �'`' �
<br /> SIGNATURE REGISTERED � N FEE CURRE Y/N
<br /> Address �?f� (,� �pr� �G ��f�� �Cicense# G�o/ � 7�
<br /> � _ELEC,TRIGIAN � COMPANY
<br /> ...,SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> � Address License# �
<br /> P.GUMBER,; COMPANY �"
<br /> -'SIGNATUR� 'REGISTERED Y/ N = Fee CU�ttten Y/N
<br /> Address License#�
<br /> .MECHANICAI;� � COMPANY .
<br /> � SIGNATURE''' � ' • REGISTERED , Y/.N FEE CURRE� , Y/N '
<br /> Add'r`ess�` � � L:icens,e#
<br /> ';�c'�. - ... . .
<br /> , OTHER:=.;�;:�:_. � � � � � COM,PANY
<br /> ;'-SIGNATURE:;�;i:= ' - � ' REGISTERED Y/ N FEE CURREK Y/N
<br /> r:�',r'?_". -, _ .• . . . , . . .
<br /> Address;;, - � - - � ' _�License#
<br /> =a>:�.:.:::. . . .. ,. �
<br /> �'��RESIDENTIAI:��,`:Attach�;(2)!:PIot�Plans;;(2):'sets�ofBuilding-Plans;(1•)°set of�LEnergy;For'ms;R�0-V11 PeRriit for new.construotion, � �
<br /> , ;u�k;x`_,r;u:�;,�,r-„•Minim,um;�.ten;(;10);working`sdays'-afte��submittal�ilate."Required''onsite�Con§truction Plan's,`Stormwater Plans w/Silt Fence,installed,
<br /> �;:�•- "'� Sanita.ry,,4FaciliNes°:&;�1,<;du,mpster;�Site.Wor,fc Petmit for�subdivisions/large'.p�ojects � ' ' � =
<br /> �;COMAAERCIAL Attach''°(2)complete sets of'Buildirig Plans'plus a L'ife Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - Minimum ten(10)warking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> �=,;��,_ Sanitary Facilitfes�1 dumpster,Site Work Permit fo�all new p'rojects.All commercial requirements must meet compliance `
<br /> `��SIGN;PERMIT `AttacFi(2fsets.of;Engineered`Flans:��� f - �
<br /> ?�:;
<br /> �p��;:,� """"PROPERTY SURVEY.required for.all.NEW construction.
<br /> :�s.._...:._ . _.._.�,__ .,.._._._._.:_ ...<,.�.__ . -
<br /> £`x�Directions: -,�:.. . , � _
<br /> • ` - Filf:out application completely.
<br /> �� � Oumer'&Contractor sigh back of application,notarized
<br /> _ lf over$2500;a Notice of:Commencement is required. (AIC upgrades over$7500) ;. �
<br /> '"= Agent(fo�'#iie�cont�actor)•or�Power of Attomey(for'tfie owne�)would tie someone with notarized letter from owner authorizing same
<br /> ?=�;OVER�,THE,COUNTER;PERMI,T,TING. (copy of contrast�.required) ' "' " � - - " -
<br /> '_:`Re�"oofs if•'shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) _
<br /> . . . __ ,._. ..._, . - - :t Y.3dr�+�d�A.uA.s�:.�u•�d�e.:u�:�iaie>��.. ,.
<br /> " D�iveways-Not over Counter if on public r`oacJways..rieeds ROW �"'�J�'� �`�� _ ,,;•:�, ,, -
<br /> 1 ..��l i��.fc`.::�1����7�:4��:�i.� •f::�'�
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<br /> �+ ��d,.,. :l�7nrpJt?Vi•:ifli�"l,�d� ^t`.V''-a�"
<br /> . ':t�'C�" 'P",.;k`,ii:t'�f.,;'{):i:.,s�s�yYJs. �i,�c�: _
<br /> � ��s..,-c,u�5��wi.�..y..�uw.x.�.o nr-,�:�•r.•.:+�.-.amtt...•;.,.
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