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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ,,,.' • Building Department
<br /> Date�eceived phone Contact for Permittin –
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<br /> Owner's Name a/�`�� { Owner Phone Number
<br /> Owner's Address � ZrG /l/�w�`� R L�� Owner Phone Number
<br /> Fee Simple Titleholder Name � Owner Phone Number
<br /> Fee Simple Titleholder Address '
<br /> JOB ADDRESS �q LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (08TAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B . NEW CONSTR B ADD%ALT � SIGN Q Q DEMOLISH.
<br /> INSTALL REPi41R
<br /> PROPOSED USE Q SFR Q COMM � OTHER _
<br /> TYPE':OF CONSTRUCTION Q BLOCK �- Q FRAME 0 ST,EEL Q
<br /> • .,� �
<br /> DESCRIPTION OF WORK DO �
<br /> BUILDING SIZE SQ FOOTAGE� . HEIGHT
<br /> I QBUILDING $�g�o 9d VALUATION'OFTOTALCONSTRUCTION
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<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ i�
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<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
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<br /> � "�
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<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER ��
<br /> S�,,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �
<br /> BUILDER -�^ COiNPANY � ���<h L C C
<br /> SIGNATURE ���� ��r �Y REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address License# ccc�.�3,�oQ�
<br /> 'ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N ' FEE CURRE� Y/N
<br /> Address - License,# �
<br /> PLUMBER..: ' COMPANY= `
<br /> SIGNATURE REGISTERED , Y•/�N FEE CURRE� Y/N
<br /> , Address ' License#� �
<br /> . .<x .
<br /> flAECHANICAL' � � ; COfNPANY
<br /> ''" SIGNATURE " REGISTERED , Y/ N FEE CURRE� ,• , ' Y/N . -
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<br /> Add�ess F `• � � License.#
<br /> „r.�'LGi,�rf'. ., . . , _ _ .
<br /> OTHER� ''?` - C:OMPANY
<br /> .."SIGNATURE�i -� - REGISTERED � ..Y/.N. FEE CURREK Y/N
<br /> _< ,,,,: ,, .. '
<br /> Address.-,;. � ,:n'.. - � = � - � Cicense#
<br /> +;�`�RESIDENTIAL�^,?. ;AttacFi,(2)::Plof':Plans;`;(2)�sefs'of�Building-�Plans;'(1•)�setofEnergy;For'ms;R=Q;W.PeRnit:fornew.constiuction,.
<br /> _ __ _ �_-.�Minimum,;ten;(.1Q)working,days after•:�sutimittaGdater�Required`onsite;Gon`stniction Plans,'Stormvirater Plans w/S(It Fence installed,
<br /> � � -J �� � �u San'itary,FaciliGes;&;�1,,dumpster;Site;,UlCo_.�IePermitfor•`subdivis'ions`/largeprojects`- - � — -- � - -- - --
<br /> ;��a.COMMERCIAL AttacFi��(2)�complete'sets of'Building Plans plus a�Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)warking days after submlttal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> �' Sanitary FaciliUes 81 dumpster.Site Work Permit fo��all-new piojects.All commercial requirements must meet compliance
<br /> ��:.._. .. .� .
<br /> �.°.:SIGW:PERMIT "Attacfi'(2)sets;_of;Engineered:Plans.�� .:
<br /> �'���"" ,"'""PROPER7Y SURVEY,required for.aII.NEW.constructfon.. ,
<br /> �Directlons: .-.,. . . . ,.,
<br /> � " FfII ouYapplication completely.
<br /> •O.wner'&ConVactor sign back of application,notarized
<br /> if over$2500,a Notice.of Commencement is.requlred.,�.(A(C upgrades over$7500)
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<br /> Agent�(for�th'e cont�actor)•or�Power'of'Attomey'(for'tFie owne�).would be someone with notarized letter from owner authorizing same
<br /> ;.OVER:THE COUNTER_PERMITTING,,.'� �.(copy_of�contract requi�ed)
<br /> '- Reroofs if sfiingles Sewers Serolce Upgrades A%C: , Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on pu6lic roadways..needs ROW �
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