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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ` Building Department
<br /> Date Received � . Phone Contact for Permitting -� -
<br /> Owner's Name S ��.� Owner Phone Number � �-��3��
<br /> Owner's Address � �O �7l T.�i�G� Owner.Phone Number
<br /> Fee Slmple Tltleholder Name Owner Phone Number
<br /> I ,
<br /> iFee Simple Titleholder Address
<br /> JOB ADDRESS O 0� � ��U '��� LOT# �
<br /> I SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED e . NEW CONSTR B ADD/ALT Q SIGN Q � Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED'USE Q SFR Q COMM � OTHER
<br /> TYPE'OF CONSTRUCTION Q BLOCK �- Q FRAME. Q STEEL Q
<br /> _ �•�
<br /> DESCRIPTION OF WORK f 8 �d/c/ S�G�7 f�.T� G
<br /> BUIL"DIIVG SIZE O CJ SQ FOOTAGE (�O �D � , HEIGHT • - �
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> �MECHANICAL $ ��v VALUATION OF MECHANICAL INSTALLATION
<br /> ��
<br /> � ��
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �
<br /> I FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO ,�2Z��2�-(�� 7
<br /> BUILDER COMPANY Q��fli�
<br /> SIGMATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address �Cicense#
<br /> • , --q
<br /> :ELEC7'RI,CIAN , � COMPANY
<br /> SIGNATURE�� REGISTERED Y/ N - FEE'CURRE� Y/N
<br /> , ��:�� -
<br /> 'Addre s - License#
<br /> Bi3- a-ac
<br /> PCUMBER.;, COMPAfVY �
<br /> SIGNATURE REGISTERED Y.-/ N- , ", FEE CURRE� Y/N
<br /> Address � Licen'se.# :
<br /> � MECHi4NICAL � COMPANY
<br /> SIGNi4TURE' � REGISTERED , Y/ N. ; FEE CURREk , ;- Y/N
<br /> Aaa�ess�� � " ' License.#
<br /> ;�s__. - ...
<br /> 07HER�� '`�,• � ' COMPAfdY
<br /> "'SIGNATURE:.� a` - REGISTERED � Y/.N FEE CURREK Y/N
<br /> Address:� ��� - = ' License#
<br /> 4`'�RESIDENTIAI:•.:,;: � , F �+ .
<br /> _. ;Attacfiz(2)::PIot�Plans;`(2�psefs of'Building�Plan§;(1•)�set'of�Energy'Forms;8=.0-1(V Permit for new.constryction,
<br /> _ ;>>:�3�Y..;:;;� -,;Minimum:ten;(;10);working;ilays after=sutimitta6date. 'Required�onsite;'Construction Plans;Stor,mvirater Plans w/Silt Fence installed,
<br /> '•� :�:,,..:,,.,. , ,•,__.. „_.. .
<br /> �- Sanitary;Facilities�&,�1�,dumpster;Site�Work Permit for-.subdivisions/large'projec4s - �'=�•
<br /> :�rCOMNOERCIAL Attach'(2)�complete''s'ets'of'Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permitfor new construction.
<br /> � - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans.Stormwater Plans w/Silt Fence installed,
<br /> ;��'.,r Sanitary FactltUes 8�1 dumpster.Site Work Permit'fo��all�new p'rojects.All commercial requirements must meet compliance
<br /> �;=SIGN`PERMIT �`Attach(2)s`ets._o,f,Engineered'Plans:�+� . ,
<br /> i'�����" "'"*PROPERTY SURVEY,required for aII.NEW.construction.. ,
<br /> • -� .-., ... . ... __
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<br /> `;Directlons: z<-:t:s_: . . , �
<br /> � "Fill:out'application completely.
<br /> . O.vimer&ConVa�torsign back of application,notarized
<br /> ' , If over'$2500,a Notice.of Commencement is required. (A/C upgrades over$7500)
<br /> '•:f� 1.:...•" .n,. ��,-e;�"�
<br /> . AgenY(for�th'e�conVactor)°or�Power of`Attomey(for'tFie-owner)would�be someone with notarized letter from owner authorizing same
<br /> �':��OVER.THE COUNTER�PERMITTING. _ (copy_of contract required) ` � �
<br /> ;:;Re�o�ofs if.sfiingles Sewers Servlce Upgrades A/C Fences(PIot/Survey/Footage) ,. � ..�:.-, ..� . --:>•.�--_�-• :-.'-_,'-
<br /> . ._' .,.... ` rt ,❑ �c�tin ,•` _ �,
<br /> ' Drivewa s-Not over Counter if on . . . � . ' . �_..�.'... .�~ .- --�=+ .{�}��-�;��:��.'j, - ;��:�`- .
<br /> y public:r,oadways:=need�`ROW"' , ,._,; u;:,,.;._:n�;�o;� ;
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