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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> . ,� - �- Building Department
<br /> Date Recelved . Phone Contact for Permitting � —
<br /> Owner's Name C Owner Phone Number
<br /> Owner's Address � 2.(� � 0 C�-'� Owrner Phone Number
<br /> Fee Simple Titleholder Name Ouvner Phone Number �
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �� �O �M Q`n� (' � LOT# �
<br /> SUBDIVISION PARCEL ID#
<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 COMfVI Q OTHER .
<br /> TYPE'OF CONSTRUCTION Q BLOCK •• Q FRAME. 0 STEEL Q
<br /> � ��� �
<br /> DESCRIPTION OF WORK �� Cl. � 1'1 i
<br /> BUIL"DING SIZE SQ FOOTAGE� HEIGHT •
<br /> ,, : ,_.
<br /> QBUILDING $ VALUAl'ION'OF TOTAL CONSTRUCTION
<br /> QEL.ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �' • �
<br /> QPLUMBING $
<br /> [�'�IECHANICAL $ � O VALUATION OF MECHANICAL INSTALLATION
<br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER CONIPANY
<br /> SIGNATURE REGISTERED Y`/ N FEE CURRE� Y/N, .
<br /> Address License# �
<br /> ;,. ,;�•;..
<br /> ELECTRI,CIAN COM PANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address License# - °a
<br /> � �,�,�_ ,.
<br /> � PCUMBER;._:. . COMPANY�;�' , - • � -
<br /> -SIGNATURE " � ' REcisrERe� ; Y/-N: ' .. � FEE CURRE� Y/N
<br /> Address ' License#',�
<br /> �y.MECHANICAL' �j , , COMP,ANY� , � C �G�
<br /> Y 'SIGNATURE''` I ' REGISTERED ,'. Y/. N . ;. FEE.CURRE� , •'/N ' � �� '
<br /> Add're`ssY� - ` � L-icense.# ���
<br /> .a;l�,,�:�"• . , , � . _ . . , , . _ � '� �' . , .
<br /> ;:OTHER��` '.6.,. ,�, , ,.�.... - _ COMPANY � , - - - II
<br /> �`=�SIGNATURE;�i�:' .'= - ' ' ' � ` ' " REGISTERED ' Y/.N. FEE CURREK Y/N�� . _ �
<br /> ' ,'r;i:,.� : - , _ .. , _ , ' �_ . ,
<br /> . `Addre'ss:�, _ - .��.:- � . • _ _ Liaerise# , � �
<br /> " _ - 'y.F'. - � y i.4,r•: " '_ � _ ',. � .. . , I
<br /> '�..RESIDENTIAL'a,�; .tittach�(2);Flot"Plans;;(2);sefs;ofYBu'ilding=P.lans;'(,1�)`set'of Energy;Forms;R=O-W;Permit;for new.construction, -
<br /> �� r��;f:rx.; - Minfmum:ten;(,1U)working°days;afte�`sutimit'tal•`date..Required'onsite Construct�on Plans;S4ormvirater,.Plans w/SIIfEence'installed;
<br /> � � f "Sanita;ry;FaciUties,8�y 1ldumpste.r•;.Sife;1lVork.Permit.f.or.sutidivlsions/la_rge�projects'�`..�, ` =- � • - _ � - _ � - - � •
<br /> '=�;COMMERCIAL Attach,(2)xomplete sets of'Building Rlans�plus a�L'ife.Safety.Page;(1)set�of Energy Forms.R-0=W Fermiffor.new.constnicti'on.
<br /> -- Minimum;ten.(10),workfng days after,submittafdate. Required onsite,.Construction.Plans;;Sformw,ater Plans vir/Silt Fence,installed, � ,
<br /> -,. � _ � ,3anitary'Facilities&1:dumpster:;Slte.Work•P.emiit'fo�%all�new p'rojeots.:All'commercial:requirements�.must�meet compliance.
<br /> ��•�.:SIGN;PERMIT -Attach'(2)sets of;Engineered�Ptans:�?�,��.�:�..,_�. ��=.- . ` �'- ' � � � - � �
<br /> �- � *'""PROPERTY,'SURVEY'tequired.;for:all.,NEW�construction.._ - _ ; -- - -- �; _ . ' .
<br /> , � - � ,., ., . , ,
<br /> ;`;`.Di�ections: � , .- . - ;� � • ' .�-� . ..., . . , � , ... .-• . :
<br /> .�. . , . .. _ ..
<br /> -- �FIII::ouYapplication completely.. _ � , "
<br /> - OwneF'&Contra�tor sign.back of�application;,notarized,; ;. �•=,:. -, , �., '� ,
<br /> ;: If over$2500;a`Notige of Commencement is:require'd:� (AIC'upgrades-ovet.$7500)`;� _.. - -
<br /> �"" AgenY(for;th'e;cont�actor)�or Power:of.Attomey(for tFie�o.wrier)would�tie�someone;witli notariied.letter"f["om owner authorizng same
<br /> ., . , ,._._. ..__. .�,- - . . .
<br /> ';;`OVER�.THE COUNTER�PERMITTING;� ::;(cqpy;of:confracf�.requ(redj.'°"'��� "' ' _ � " " � - ,'
<br /> -°Rero'ofs if`shingles ' ��Sewers .',:.-}:;Seniice�Upgr'ades�.i41C ' Fences(PIot/Survey/Footage)• "
<br /> , - � � Drlveways-Not over.Counter if:on.publio,r'oadways:.neecls ROW,.- � � � , � �
<br /> , ;. , ,. . - - ,- � � �.;-
<br /> � _.._ � ' � - _ •-- - •-•-- ---- ,,
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