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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 II
<br /> °• Building Department
<br /> , � 3
<br /> Date Received
<br /> 2 � � r Phone Contact for Permitti�g � �� y�1 — �
<br /> Owner's Name �Q ���� ��� I� / �d/�� Ovvner Phone Number
<br /> Owner's Address Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS CT 6I�j LOT# �
<br /> SUBDIVISIOIV PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED .. NEW CONSTR ADD%ALT 0 SIGN Q Q DEMOLISH
<br /> e INSTALL B REPAIR
<br /> PROP,.OSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE"OF CONSTRUCTION Q BLOCK •• Q FRANIE 0 STEEL Q '
<br /> DESCRIPTION OF WORK �Y�P � p) `]�Q �� � t✓ GR/" � h4� l°/�5
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRIJCTION
<br /> QELECTRICAL $ C. ��, �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> /
<br /> ,•' •
<br /> QPLUMBING $ ,
<br />�I OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br />� QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br />' FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -BUILDER COMPAPIY
<br /> SIGNATURE REGISTERED Y"/ N FEE CURRE� Y/N,
<br /> Address License#
<br /> ELECTRI,CIAN .,. .. � COMPANY Q /C ��CG���G
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y'/N
<br /> ,;.,:' . n i+ ?
<br /> Address� " 7 D /' � /Cr /G��' License# G DOD �
<br /> � P.CUMBE�t;;..: COMPA(dY- ;�:- � ' '
<br /> -SIGNATURE `REGISTERED , Y.•/"N�-` ; •FEECURRE� � Y./N '
<br /> I , . ..
<br /> Addre�s. � � License#'
<br /> :":MECHANICAL_ , ' � , COMPANY - �
<br /> '' SIGNATURE``� � ' '`° � ' � REGISTERED �,' Y.,/ N . FEECURRE� Y'/N ' �� . �
<br /> „ ;": ..,. ... . . '
<br /> Adii�e'ss=`� � ' � � License# �
<br /> �„i..�:,... _ . .
<br /> ;: .OTHER�= •�:'' .'- ` ',: � � " ' COMPANY - -
<br /> �'SIGNATURE�S.,:,�< - ' •� � � • � " ' ' '�REGISTERED Y/ N. � FEE CURRE�' Y/N
<br /> - - 'Y: ' : . , �. '•
<br /> ;Address. , - ;:� - � - � License# , ., , . _ -
<br /> :s;: -
<br /> _ �, :'. ' . . �:<' . . .� . .. , .., . � -
<br /> =5i:�:i�'; " '" _ ""
<br /> _NRESIDENTIAL�", Attacfi`,(2):PIot�Plans;`'(2)�sefs�of`Building��Rlan's;�(�1•)`set of�Energy;For'ms;.R=O-W:Permit for ngw.construction,- _
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<br /> _ �.:,�-v���---�Minimum':ten:(,10)working;days'afte�"sutimittal=date..°Required=orisife;�Constniction'Plans;:StormwaterPlans:w/SiltFence;(nstalled;
<br /> :�?,�_.s:-�.,�.,_ �„ :.. . . - - �
<br /> „' �Sanita,ry�,Facilities�&;.1�dumpste,r.•,:Site;:Work.P.ecmit.for;§ubdivisions/la,rge'p�ojects .: `� '='_� • - - - - - � -
<br /> `�_COMMERCtAL_ ' Attach'�(2)complete sets of Building Plans�plus a�Life Safety Page;.(1)seYof Energy�.Fomis:R-0-W Permit fo�'new const�uction, - "
<br /> s;:r , ,' . . -Minimum ten(10)working days after;submittal date. Required onsite,:Constriictlon Plans,Stormwater:Plans wL3ilt Fence fnstalled,. �
<br /> �:' "..' �� .:.;,.- ' •Sanitary•-Facilides'8'1•dumpster:Site;Work,,Pemiit fo�all=new p'rojeots.All:commercial�requirements`,must;meet compliance. �� �
<br /> >'SIGN`PERMIT,�' ��AttacFi(2)�sets:'of:;Engineered Plan,s:�;,.��:,:-�• _ ' , , " ` `"- � � _
<br /> � _ '*'*PROPERTY�Sf1R�%EY,�equi�ed°.fo�:a11;NEW'construcBon:- , , �- - _ ,
<br /> �Directions:. - - � ,. ....- - , . . -: .:..' .. -,. . . ,
<br /> _ _ �Ffll:outapplication,completely:''' -• _ "
<br /> ' ' Owrier&Cdntraator:sign:6acR of.`applfcation;-not'a�iied'� . ; , �•� � .
<br /> � ` 'Ifover$2500;a Notice.of.:Commencement.is requ'ired:.,(A/G:upgrades.over;$7500).- ; ,
<br /> '';" Agent;(for`tFi'e�cont�actor)or Power of'Attomey,(for'tFie�oinrrier)_would:tie.�someone,with notarized I@tterfroin owner authoriiing,same'� I
<br /> :;:�OVER:THECOUNTER`.PERMITTING.� _ ".(cgpyofcontract�:requi�ed):'��i��`;�`.'� � , � . - ' = � ' � ,
<br /> -_ 4Reroofs if shingles, . ��Sewers; - '.Service:Upgrades A%C Fence$�(PIoUSurvey/Footage)• "
<br /> ' -� _� ...,.,, . . _ : .. ... .. �: .
<br /> ,. _ : -, , ...
<br /> +Driyeways;NoEove�`Counter.if,'on;public'�oadways.:needs"ROW � ' ' ,,,
<br />� _ , . , _ .. ; , - _ � x
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