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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> •• Building Department
<br /> � = -
<br /> Date Received
<br /> Phone Contact for Permitting -` —
<br /> Owner's Plame Cc�� V � Owner Phone Number
<br /> Owner's Address ��'�l U 'i'" - Owner Phone Number
<br /> Fee Simple Titleholder Name Ow+ner Phone Number
<br /> Fee Simple Title6older Address
<br /> JOB ADDRESS � � V � � LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e .. NEW CONSTR B ADD7ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> � PROP.,OSED USE Q SFR Q COMM Q OTHER
<br /> TYPE'.OF CONSTRUCTION Q BLOCK •- Q FRAME Q STEEL Q
<br /> DESCRIPTION"OF WORK . �i W�� c� . �� �
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ /t ��vv VALUATION`OF TOTAL CONSTRGCTION
<br /> `l
<br /> QEI:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> ��'' • �
<br /> OPLUMBING $ ���
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ���
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER -- COfNPAIdY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License#
<br /> , ELEC,TRI,CIAN , COMPANY
<br /> . SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N
<br /> Aildress l:icense#� > � "y
<br /> PLUMBER.,.; . COMPANY � • • '
<br /> ,�SIGNqTURE� - - •REGISTERED ; Y•/"'N. : '" FEE CURREK' � Y/N �
<br /> `! - �
<br /> Address �'•License# �
<br /> :,'.MECHANICAL` � � COMP.ANY �
<br /> '` SIGNATURE`' ' �• � ' ' REGISTERED , Y/ N FEE.cut�E� , Y/N: �- -•
<br /> .S� .. .. . _
<br /> � Add�e's`s•" � ` ' � ' ' Licens,e.#
<br /> n,;i::, ,
<br /> _ OTHER��_�:�. , ' . ' ' 'COMPANY =
<br /> _ `_''SIGNAtUREa;':- - ' ' ' �REGISTERED Y/N, FEE CURREK Y./N „
<br /> .. •r,1. :••::r'.. _'c x� _ " ' . �` . . � , _ ..
<br /> � � �Address:�, . . . -.�s� - �.. , , Licen'se# , - �
<br /> - ;F:��3>�:`� _ _ •''� - _ .� � �`-
<br /> =:RESIDENTIAL� ` AttacFi=2`.Plot Rlans�'-2 isets�'of�Buildiri ;Plans;�1��set'of�Ene_' 'Forms;R-0 V11.:Perrr`iit for new constiuction,, _ -
<br /> -, ,� ). �.� ) -. . 9 �_.),.. r9Y;.,�..- . - :r�.;_
<br /> _ � � �, ,_-��-;�-,aMiNmum�;ten:.(,10.)"woiking;days';after;"s`u6mittal:date:!Required�onsite;'C �4j � �\
<br /> ' -� ' � onstniction`Flans;Stormwater:Plans,w/.Silt Fence�installed, _
<br /> `^ '"?,. ,;.s..;.- , ,�> . . . � . , , �. . .,_. , � •- - - , ; '
<br /> ,-- _. _ ��� -3anitary;Facilities18��1�;dumpsfer;Sife;.,W.o[k Permit:for',subdivisions/large�projects � _ • - - � -
<br /> �'_.COMMERGIAL' Attach�:(2)�complete sets�of Building Plans.plus a,L'ife Safety Page;(1)set;of Energy Forins:R-O-W.Permit foc new.construction.� , ,
<br /> , ° Minimum.ten�(10)'wo�king day,s.after.submittal�date. Required onsite,.Construction:Plans;Stormwate�Plans�wl Silt Fence installed,.=: .. , �
<br /> :. '" � � �San(tary•Factltties 8'.1�dumpster.Site_Work-PeRriitfo�%all-new,projects.All.wmme�ciaLrequirements;.mustmeet,compliance �
<br /> s�.SIGN:PERMIT '�"Attach(2)sets:of<<Engineered;Planscs,r:.'; � �.- :.' � � �'" ` ; , � �
<br /> - ' � - """PROPERTY.SURVEY��equired;for...aII;NE .W.�construcUon:.; _ -_ _ � �. ' � _ -
<br /> �;Directions: , . : , . , .. � , , ._ _. _ ` , . ,. . .. , -
<br /> ': �'�� ;Fill out applicatiom completely.�:�;,;,�� ' �..
<br /> �• ,.�puvner.&Contraotor.sign:6aok.of.�application;'`notarized~ ' � � ,.. ' -
<br /> •- - ='If over$2500;.a'Notice.of Commencement is,requir,,ed.;,'(A!C upgrades�over$7500)'' _ - _-, ,
<br /> _ ' ' Cs :,.::�—.y -- �; _ �.r,I�t .'
<br /> ��"'`" �.Agent(forth'econtFactor)'or;'Fower`oY.Attom'ey'(for;tfie�'owiier),,virould'tiesomeonewith';notarized,letter:'-from:ownerauthoriiing.same
<br /> �°�OVER.THE'COUNI'ER=PERMITTING.'`�__,'-r(copy.ofcontract=requ'i�ed);., ` � , - - - � -
<br /> �•�.�R'eroofs if'shingles_ "'-'Seuvers;1- - ;SerVice.Upgredes.,A/C Fences(Plot/Survey/Footage) '
<br /> _, Drlveways=Nofove�Counter�if.on.public roadways:.needs ROW, � � , -
<br /> - � ._.... _ , .� . -- --- �;�;���
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