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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 /> Owner's Name �� C� � � ,�,(� Owner Phone Number �. — � d".�=�3 Z
<br /> Owner's Address � d �G� ��/� Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS O �/>G� Q4 l/� � LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (08TAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B ,. NEW CONSTR B ADD7ALT � SIGN � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP,.OSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE'OF CONSTRUC770N Q BLOCK •- Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK % l/f/� f� � G�SJ'�f'G�j�
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT �
<br /> �BUILDING $
<br /> ,��Q O VALUAl'ION°OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> t. .
<br /> QPLUMBING $
<br /> ��'�f�
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ` �
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER ,
<br /> FINISHED FLOOR ELEVATIOIVS FLOOD ZONE REA QYES NO
<br /> -BUILDER COMPANY L/'�(J/L��i�
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/IV.
<br /> Address �License#
<br /> ELECTRI,CIAN :.; - COMRANY
<br /> :. SIGNi4TURE REGISTERED Y/ N FEE'CURRE� Y/N
<br /> Address � License# . � ` ��
<br /> ' A . „ �
<br /> PLUMBER,,.;, , . COMPANY�� : �- - ' •
<br /> ,�SIGNATURE � -REGISTERED ' ; "Y.•/"'N, " FEE CURRE� � Y/N
<br /> Address, � License# , .,
<br /> > , ,�,� . _ . ,
<br /> °'.MECHANICAL` , , � . COMPANY •
<br /> ' SIGNATURE'�" ' � ' ' REGISTERED ,' Y/, N: -� FEE CURRE� Y/N ` � .
<br /> ' :r.�„ � , '
<br /> Add�e'ss��.' ' ' ' . Licens,e.#. -
<br /> '�jii� ��:� . . . , , . , -
<br /> �OTHER�K�• ,.Y: . _ � ` ` , � � . . COMPANY , . .. , �
<br /> ,,
<br /> ,.�';SIGNATU_RE_. .- �� REGISTERED Y/ N... FEE CURREK Y/N - ,
<br /> _ �. .:Address,• .:� . .� . .;. .. � .. . Lioense;.# - ' _' ,"
<br /> ,_+}`' _ �. ,
<br /> �-.�;,,�" - _ . . _ ;-,F;;,. - _ ::�k�,;,.::' _ „ ._ . ., ,., . .
<br /> .�RESID.ENTIAL'„;:?:Attacti:;2:°Rlot`;P.lans;'�2 sets:ofBuildiri� Rlans;�:1-�sef.of�Ene� 'Forms,.R-O-VN-;Fermitfornew.construotion;"'�� �
<br /> . _ _. _.. � .) . .. �.) . . 9 �_). ,... �9Y. ,., : ;
<br /> _ - � ,�;;;�-,��s�`;=:Minimum'sten,(110.)�:working"day's��afte�,sutiinittal�date.'Reguired�-onsite;Consfriiction°Plan's;-Stormwafer;Plansw/Silt Fence installed,
<br /> " ` �8anitary-,FacilfUes&1,du'mpste{;,Site Woric-Permitforsubdivis'ions/large`projects��_ . - , . ` .-- - -
<br /> :,. .r
<br /> ��';;EOMMERCIAL - Attach'(2)complete sets`of'Building Plans�plus-a L'ife Safety.Fage;,(1)set of:Energy.Forms�,R-O-W R,ermit fornew consUuction. " ` ,
<br /> -� ' � Minimum den,,(10)working day,s afteF,subrriittal date. Required onsiCe,.Construction:Plans;•Stormuvate�:Plans wL Silt Fence install'ed,; -
<br /> ��- ` • San(tary'Facilitles 8�;1`.dumpster.,Site;Work P.emiit'fo�;all-netiv.p'rojects..AlLcommercial.requirementsmust.meet.compliance �
<br /> _�_,SIGN=PERMIT '""•Attacfi`(2)'sets,.o_f,Enginee�ed•Flans:�'�� ���,.�� -� - � • � � � ,
<br /> - . ,�"**"PROPERTYS.URVEY;�equired;for.all:NEW,�con"strucdon:-_ _ _ _ _ �, , - _ , `
<br /> ;DiFectlons:. , - . . � , . . Y ... _ . � . , - _ .. =
<br /> - =Fill out application completely.� • - � �
<br /> O.uuner:8 Contraotor.sign,back.of.:appliqation;,notariied :�.` :• ,: � -
<br /> � If,-over$2500,a`Notice:of:Commencement;ts:required::,(AIC upgrades:�over;$T500)`, _;; ; „ ,
<br /> ,.,;�., .
<br /> `:�""'� "A ent,fortFi'e'cont'racto_r'or�Power of'Rttome -for_:tFie=owner would be�someone:with:notariied:letter.from owner.authorizin same �
<br /> Q � ) Y� ).�. 9
<br /> -.. ,> - ,
<br /> , �. . � , _� �
<br /> ::OVER.THE COUNTER:PERMIi•TING. ...;,`'-,(copy of contract�requireii)"�, =��',',,, ;:
<br /> ��
<br /> '•��;Reroofs•if.shingles: �. Sewers• '- ,=.-SerVice.Upgracl'es,NC Fences(Plot/Survey/Footage)., " �-
<br /> . _ - ,... _ ..�.. -• � �;:,. _ -_ - _ - � - - � � .r
<br /> ;Driveways-Notoye�.Counter�if:on.putilic�roadvuays::needs'ROW; ' � � , . : -
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