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s��-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department
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<br /> Date R'eceived phone Contact for Permitting �� �1� ��� - ��
<br /> Owner's Name � ���� 1V� - Owrner Phone Number
<br /> Owner's Address ��4 U �"1�'� � � �vJ ' Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e � NSTALLSTR B REPi41R � SIGN Q � Q DEMOLISH
<br /> PROP,OSED USE Q SFR Q COMM � OTHER
<br /> TYPE':OF,CONSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q I
<br /> DESCRIPTION OF WORK ����'Fi S l�h I
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ ��
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ��
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVAT O S FLOOD ZONE AREA QYES. NO
<br /> BUILDER CONiPANY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br />� Address -Lieense#
<br /> , 'ELECTRI,CIAN COMPANY —
<br /> . SIGNATURE REGISTERED Y/ N FEE CURREI� Y/N.
<br /> AcJdress - License# "
<br /> , A
<br /> P.CUM,BER;,. , COMPANY �
<br /> SIGNATURE REGISTERED Yr/ N � FEE CURRE� Y/N
<br /> Address License#
<br /> �- .MECHANIGAL � � COMPANY
<br /> '- SIGNATURE�' � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Add're"s's�" ' � " License.#
<br /> �:c;y•: -
<br /> ,:.OTHER" �"`'= = COMPANY
<br /> .;' SIGNATURE:>,.:<<. .�' ` ' - RE�ISTEREo Y/ N FEE CURREK Y/N
<br /> �a ... � , �
<br /> �Address�-, F,; - - � °License#
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<br /> ���`'RESIDENTIAL��:;�'�Atfacli;(2)sPIoY P.lans;'(2)�sefs•of_Building�Plans;(1-)°set of�Energy,For`ms R=O-Vi/,Permit for new.construction,
<br /> "�-;u:1:�•=;Minimum 3en„(�10),working;days afte�submittal.date. :Required'onsite;Gonstruction Plans,�Stormwater Pla�ns w/Silt Fence installed,
<br />- �,:,�:' , ���'�"" ��8anita..ry,,Facilities,&r,1,,dumpster,Sife�WoricPermitfoc;subdivisions/large'p'roJects` � - �• �
<br /> , .:COMMERCIAL Attach`(2)�complete sets of'Building Plan"s�plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> - - Minimum ten(70)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence,installed,
<br /> :�x;,_,
<br /> ;;,_- Sanitary Facilities 8�1 dumpster..Site Work Permit"fo�'all new projects.All commercial requirem.ents must meet compliance
<br /> ;,-.SIGNPERMIT "Attacfi"(2)sets:of;Engineered,Plans.�� � . � �
<br />, "'"PROPERTY SURVEY,required for.all.NEW construction.
<br /> ,r� a
<br /> ',Di�ecttons: .. >:�t== . .. x
<br /> ---, Fill:out application completely.
<br />' �� 'Owner:&Contractor sign back of application,notarized
<br />�� If over$2500,a Notice of Commencement is requlred. (AIC upgrades over$7500)
<br /> i '�Y,., � .�..,.; .,.«.� �
<br /> . _ Agent�(for'th'e•cont�actor)�orPowerof Attomey(for'tlie�owner)would be someone with notarized letter from owner authorizing same ,
<br /> ;_;OVER.THE COUNTER_PERMIT:tING,_ (copy_of contract-requlred) � � I
<br /> ��'Re�oofs if sfiingies Sewiers Service Upgrades A/C Fences(Plot/Survey/Footage) ',
<br /> Driveways-Not over Counter if on public roadways..neeils ROW �
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