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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> °- Building Department
<br /> Date Received '
<br /> �Phone Contact for Permitting � —
<br /> � 3/�- s�3�-- �� <9 �%�,
<br /> Owner's Name d/1 /1 y1 Owner Phone Number
<br /> Owner's Address �� � � � Owner Phone Number �1.�� /.5 /� l�`T I ��'/�iL
<br /> Fee Simple Titleholder Name Oxiner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS (�S ��JO�� LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED ,. NEW CONSTR ADD7ALT Q SIGN Q � Q DEMOLISH
<br /> e INSTALL e REPAIR
<br /> - PROP.,OSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE`OF CONSTRUCTION Q BLOCK •• Q FRAME 0 STEEL Q "
<br /> � .
<br /> DESCRIPTION OF WORK • r`���� 4���
<br /> BUILDING SI SQ FOOTAGE�� HEIGHT •
<br /> BUILDING $ �3 DU, VALUAl'ION°OF TOTAL CONSTRUCTION
<br /> �
<br /> QELEC7'RICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> QMECHANICAL $ VALUA7'ION OF MECHANICAL INSTALLATION
<br /> Q_GAS ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -BUILDER d?�� (.v`Z2���.9�(/"✓(/ COMPANY �/'2�lr7YJ.Q/ G���/�'y[XiV
<br /> SIGNATURE '�- REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � License#
<br /> -;:r.. ;. • ..
<br /> ELECTRI,C-,IAN _ COMPANY
<br /> . SIGNATURE REGISTERED Y/ N FEE'CURRE� �. Y/N.
<br /> Address License# _ - ",
<br /> -:�•: . .. , , , , , .
<br /> P.LUMBER.;:; • -COMPANY' . : . ' .
<br /> -�SIGNATURE � - �REGISTERED ; Y,•/ N� ' " '" FEE CURRE� � Y/N�
<br /> Add�ess License#=.
<br /> •�".MECHANICAL. _� . • . , COMP.ANX, . -
<br /> �-'`SIGNATURE'"'' ` REGISTERED ,' Y/ N . ; FEE CURRE� Y/N =.
<br /> Aaa�ess��- � � � . . , � - " License.# -
<br /> ;ri� •� .... . , _
<br /> �.OTHEPt:i�",;:.;� - . ' . ' ' � � 'COMPANY � �
<br /> ��SIGNATURE:,_. - - " � "
<br /> . .- REGISTERED Y/ N. FEE CURREK Y/N
<br /> -- ,. ' -- , � _ , - - - , . , �,_ - . .
<br /> - Address��,+_ _ - � - � � ,_ - . , Licen§e# � . � '
<br /> ;- - - 7,.:,�..>t,;:..;:::.�<.��.;�; n<�,,:. - ,;�;,� -,' ;.�:,.(;,,::;:. . .. . . .
<br /> :_RESID.ENTIAL��„_•.AttacFi`;(2)>Plot Plans;�(2)�sets�of Building�Flan§;.(1�)`set`of�Energy;Forms;R-0;=V11.:Permit.for new.constniction�"�` -�
<br /> =. , , . , ,
<br /> `" "-;°:;�•�,t,-�.'-�`-�:Minimum::ten:;1'O..workin�;da�s'after�submittal?date::'Re. uired'onsite;Constni'ction�Flans;Stormwate�.Rlans�w/Silt-Fenoe�installed �
<br /> - �,:�.;ti,:;�,.o.,_ W,,., .... . �...) - ,.9 . Y_ q
<br /> .�:�r . , . .. ,
<br /> ,._ .
<br /> .., .s.,n , . , ,
<br /> _ - • - Sanitary�,Facilitles,&,��1�;dwmpste.,r•,`Sife'.Work_Permit:for'subdivisions/large"projects.';; :- �<;.� ` _.__. _ _ _ ._ : -_
<br /> ���.COMMERCIAL Attach.'(2)�cgmplete sets;of;BuiliJi'ng Plans=plus a Life;S.afety Page;.(1)set�of,En,ergy;Forms:�R-O-W�Permif;for.new.construction. - •
<br /> ' � _ , � � .Minimum ten.(10),,working�tlays�.after subrriittal`date.;Required onsite,.Constiuction Plans;;Stormwater Plans w/SilfFence installed, � -
<br /> � "� � " �SaMtary-FaciliUes:B'1;:dumpster:.Site;Work;P.errriit"fo��al�'new,projects.All;commerciaCrequirements.must.meet.compliance '
<br /> �SiGN�.PERMIT> -AtfacFi{2)sets of,Engineered,Flans:-�.'; � _ : _ , .. - � - -
<br /> _ -� . . "'"'PROPERTY SURVEY�egui�ed',fo'e:aII:NEW�construction:.:. _. `_ - • � - - • � �
<br /> '�Dicect'ions: `.r. ` . �:�:;-;ti':. , _ .•.- -. ... . _ _ • , .., . , ._
<br /> -; �Fill':ouYap'plication.bompletely;;;", • � � - ,. =. ���' . , .
<br /> Qwner�8 Contracfor�sign.back of�application;notanzeii� -. . ��- � ' .. .
<br /> 5�� If over$2500;a.Notice°,of?Commencement ts,required._ '(A/C upgrades.over,$7500);�;-. . , ,
<br /> �""'-'_ A'ent fortFi'e cont�aotor'orPower,ofAttome ;:for�tFie�o.wne�:would tie�someone;with;notarizedletter`from:ownerauthoriiing_same
<br /> 9 � � )� . Y� ) ,. �
<br /> ;=OV.ERTHE�COUNTER;PERMI7TING :.�,(copy,of contract:required)::�-""'�:,'`` - • - _ � ..
<br /> ;��`.Reroofs:.ifshingles. � �.'Sewers --��_'Service.Upgradesj.A/C � Fences{Plof%Survey/Footage) � �
<br /> � ,�,- _..;�=,-,-; - '- � � � -.. � - ,
<br /> ' : D�iveways-Not oVer Counter if.on'.putilic�roadways;.`neecls`ROW � `, ' " ,
<br /> �:` . .. . - • .
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