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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �Y �.;
<br /> ,;�� � � Building Department
<br /> Date Recelved Phone Contact for Permitting -� —
<br /> Owner's Name Owner Phone Number
<br /> Owner's Address �1`�`� � � � � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Numb�r
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �Fr � � LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e . NEW CONSTR 8 ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP.OSED USE Q SFR Q COMM 0 OTHER _
<br /> TYPE'OF CONSTRUCTION Q BLOCK �• Q FRAME Q ST.EEL Q -
<br /> DESCRIPTION OF WORK i �1 (� '�V -P C��
<br /> BUIL"DING SIZE - SQ FOOTAGE . HEIGHT �
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTROCTION
<br /> QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ��� �� �
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 7 N
<br /> Address License,#
<br /> -'ELEC,TRIGIAN C+`„'" ' COMPANY C L� I�G �C� L -P f/�Cc,' C 0
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ! 7� License# (�c_. DDv �Z(P
<br /> � � •
<br /> PI:UMBER, COMPANY=,
<br /> SIGNATURE rt��isTEReo Y.-/ N'� � FEE CURRE� Y/N
<br /> , Address License,#`
<br /> - MECHANICAL � COMPANY -
<br /> " SIGNATURE�' � ' REGISTERED ,' �Y/-N' FEE CURRE� � Y/N _.
<br /> _ � �
<br /> Add'ress''' - ` Licens,e.#
<br /> ,,:i::�.�� .,
<br /> ; .OTHER;�`"":• � C:OMPANY
<br /> `�`�SIGNATURE'u� :s .� ���sTERe� Y/ N FEE CURRE�' Y/N
<br /> ,,,. , .
<br /> Address��.; _ -• � License#
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<br /> �;.:RESIDENTIAL�sa; -Attachr(2);PIof;P.lans;�'(2)'sefsofBuilding'Pians;r(1•)'setof�Energy_Forms;R=.0-1(V,.Pertnit,for'new.construction,
<br /> �a�..r�.�,�,A,,,;Minimum�;ten:(;10);wo�king;days.aftersutimit'tal�dafe.�Required�onsite;'Gon`structionPlans;StormwaterPlansw/SiltFenceinstalled,_
<br /> •.�-�;, i"� �� San'itary�Facilities;&�1�dumpste�;�Site;Wor,k�Permitfoc,subdivisions/large�projecfs'_ ' ' �
<br /> r�, � ) P � 9 .. P . - tY 9 � ) 9Y
<br /> ;�;COMMERCIAL Attach'�2�com lefe'sets`of'Buildin`"Plans lus a Life Safe Pa e; 1 set of Ener Forms.R-O-W Permit for new construction.
<br /> -- Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, - -
<br /> -- Sanitary Facilities�1 dumpster.Site Work,Permit fo��all•new projects.All commercial requirements must meet compliance
<br /> :�•, ... ,
<br /> r=:SIGN�PERMIT �Attach'(2jsets_of;Engineered;Plans:�<� ,
<br /> ' ' ""'"PROPERTY SURVEY required for aII,NEW.construcUon:.
<br /> �`- ._ •
<br /> o�;DireCt(ODS: r+=';. _ . , �
<br /> Y ' �Fill,outapplicationcompletely.
<br /> . Owrie�'&Contractor sign_back of application,notarized
<br /> , � If over$2b00,a Notice.of Commencemeat is required. (AIC upgrades over$7500)
<br /> ..TM ,.,.:: .....:....:�
<br /> Agent°(for'tKe�c"ont�actor)�or�Power of Attomey(for'ttie owner)would 6e someone with notarized letter from owner authorizing same
<br /> :�sOVER'.THE COUNTER`PERMITTING. (copy_of•contract-required)
<br /> �'Re�oofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> " Driveways-Not over Counter if on public`ro'a'8ways.:needs ROW
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