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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • ' Building Department
<br /> J �
<br /> Date Received
<br /> �Phone Contact for Permitting –
<br /> v� / �7� � /� Owner Phone Number /7� — �
<br /> Owner's Name �
<br /> Owner's Address ;�j2 � lPD -�J�i � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ��L� ���� � LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROiN PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e . NEW CONSTR e ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL REPi41R
<br /> PROPOSED USE Q SFR Q COMM Q OTHER :
<br /> I TYPE`OF CONSTRUCTION Q BLOCK �- Q FRAME. Q STEEL Q
<br /> DESCRIPTION OF WORK `1 .�.c�i/ � � / Z--
<br /> BUILDING SIZE SQ FOOTAGE�� , HEIGHT �
<br /> BUILDING $ I G��QF �� VALUATION'OF TOTAL CONSTRUCTION
<br /> /
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ����L
<br /> ��'' l
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �1;1f�
<br /> VI
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �Cicense,# �
<br /> 'ELEC,T:RI,CIAN , COMPANY ' -
<br /> SIGNATURE REGISTERED Y/ N ' FEE CURRE� Y/N.
<br /> ' Address License# �
<br /> ,F` "
<br /> P.LUMBER,. • COMPANY
<br /> SIGNATURE REGISTERED- ;' Y.-/�N:� .'� :FEE CURRE� � Y/N
<br /> Address �License#� :
<br /> . , ,� -
<br /> MECHANICAL � COMPANY
<br /> SIGNATURE� � ' REGISTERED ; Y/ N FeE:Cuw3En Y/N '
<br /> Add�e'ss�= �• � ` License_#
<br /> ;c:_ .� .
<br /> . OTHER� �'. - � " � COMPANY
<br /> °:`=SIGNATURE�:>,•� • REGISTERED Y/N FEE CURREK Y/N
<br /> ' :;. . � ' . '
<br /> Address„� - � " • � Lioense#
<br /> ��RESID.ENTIAL��;; `Attacfi,,(2)�;Plof'Plans;`'(2);setsof�Building`Plans;(1•)`setofEne�gy,For'"ms;R�O-W P.errriit.forn.e_,w.construction,
<br /> ;�;�,;�_�;:.<,��Q-aMinimum�ten�(1Q);working;daysiafter�submittal�date.�Required onsite;Con`struction Plans,'Stoimwater Plans w/S11t Fence installed,
<br /> �; ,
<br /> i.-. �Sanitary;FaciliGes.&�4lydumpster;:Site:.Wor,k Permit foc`subdivisions/large'projects�.- °
<br /> ;��.:;COMMERCIAL Attach`(2)'complete'sets of'Buildirig'Plans'plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - - - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed,
<br /> ;iz`: Sanitary Facilities 81 dumpster.,Site Work Permit fo�-�all.new projects.All commercial requirements must meet compliance
<br /> „.-rSIGN:PEP2MIT "Attacfi'(2)sets_.of�;Engineered Plans:t� ,, ,. - -
<br /> �`� ""PROPERTY SURVEY,required for aII,NEW.construcUon:
<br /> S�` '
<br /> �"':Diiections: . .. . , .. �
<br /> � '" Fill;out application completely.
<br /> - Ouvner'&Contractor sign back of application,notarized . -. - . , . _ �, ,r
<br /> ;-'- If over$2500;a Notice of Commencement is required. (A/C upgrades over$7500) , - ? � � ' "' ,
<br /> ._ ., .,. :,: .
<br /> Y.,.. . ..Y�;,:,, .
<br /> •, Agent(for�4li'e�cont�actor)•o��Potnrer of Attortiey;(for;tfie owner)would'.be someone with notarized,letter from�owner auttiorizing same�, �._
<br /> -. - :�.__ , ` � � , � �
<br /> ;..`�:OVER�:tHE COUNTER PERMITTING>�'_;.: �i(i;opy of confract reyuired)� ;, ' � •. , `„ " "�
<br /> '::Re�oof§if shingles Sewers ;"Ser`v1ce�Upgrades A!C Fences(Plot/Survey/Footage) � � -�- �. .n - - . F, .�_,..�,
<br /> � Driveways-Not over Counter`if�on"pu61'ic roadways..neeils ROW � �
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