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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> ' • Building Department
<br /> Date Received p--��:�, phone Contactfor Permitting���
<br /> � • Q� �- � 6
<br /> Owner's Name � ' � Owner Phone Num r
<br /> Owner's Address � p r /�/ • Owner Phone Number �
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS .,/�✓ U.GYI.I { �i �/�� fy /I ,4 /L LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � ,, NEW CONSTR e ADD/ALT Q" SIGN Q � Q DEMOLISH
<br /> INSTALL -REPi41R
<br /> PROP..OSED USE Q SFR Q COMM 0 OTHER .
<br /> TYPE:'OF CONSTRUCTION Q BLOCK • � FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK + �(7�G/ S�pN G�� �
<br /> BUILDING SIZE f �, /11 7 �, SQ FOOTAGE �7 � HEIGHT • j �, .
<br />� �BUILDING $�� CO.oO VALUATION�OF TOTAL CONSTRUCTION
<br /> 7
<br /> [�ELECTRICAL $ AMP SERVICE�OQ Q PROGRESS ENERGY Q W.R.E.C.
<br /> �PLUMBING $
<br /> �l�22� i,�11�,
<br /> , � �U�`� '
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �IJ� � _ G �,
<br /> � ���
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> D n�t c.►Ke�"
<br /> BUILDER !�� COMPANY
<br /> SIGMATURE ' REGISTERED Y�/ N FEE CURRE� Y J N
<br />' �4ddress �33 A. G � �/ �'� � -License#
<br /> . 0��0 Ij'P.9/' � : ����,
<br /> 'ELECTRI,CIAN �1 COMPANY �����v�(`P!�
<br /> -. SIGNATURE � � REGISTERED Y/ N FEE CURREA Y/N.
<br /> Address 33 • P�[�� r/ - License# "
<br /> tf6 c.or�i��e.!'' �� ' -
<br /> PLUMBER.>, •COMPAPIY
<br /> �SIGNATURE ' �� REGISTERED Y•/:N. ` FEE CURRE� Y/N
<br /> / /'
<br /> Address ,3 al.��,Gy,/ e � License#' .
<br /> MECHANICAL � COMPANY
<br /> ' SIGNATURE�" � ' � ' � ' REGISTERED - , Y./ N . FEE CURRE� . .' Y/N
<br /> Address�• � � . License.#
<br /> .},«,;;: ... .
<br /> I ;; OTHER= ,:�'��- ' � COMPANY
<br /> `SIGNATURE:•_.,���, -
<br /> . � - REGISTERED Y
<br /> / N FEE CURREK Y'/N
<br /> ` t::. , � "
<br /> Address.-. -- • - � License#
<br /> " �+.:. - - .
<br /> �:.RESIDENTIAL,;: :Attacfi:;(2)?PIot:P.lans;:(2):set`s of`Building��Plans;(1�)�set ofEnergy'Forrris;R;O-VU Permit.for new.construction,
<br /> ,_ =_�,�-_�. r.-:Minimum;ten;(,10.):working?clays'after;subinittal:date."Requireif�onsite;'Construction Plans,°Stormuirater Plans w/Silt Fence installed,
<br /> - , M.:ti-.,-�.-e.., �_ .-,x: ,.
<br /> '��...- �� Sanitary�Facifities,&�.1�,clumpster;Site;,Work Permit for,subdi'visions/large?;project"s�.. • .
<br /> �'�:COMMERCIAL Attach(2)�complete sets of Building Plans�plus a L'ife Safery Page;(1)set of Energy.Forms.R-O-W Permit for new construction.
<br /> - Minimum ten(10)workfng days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> �;;: Sanitary FaciliUes 81 dumpster.,Site Work Permiffo�•�all new projects.All commercial requirem.ents must meet compliance
<br /> :• SIGN'PERMIT -Attach(2j sets oftEngineered'Flans�_.. �::� ..
<br /> - - """"PROPERTY SURVEY,required.for.aILNEW.construction.. . � ,
<br /> ',Directtons: . .._ ., .,. , �
<br /> _ �Fill-out application completely.
<br /> Owne�.&Contra�tor sign.back of appNcation,notarized
<br /> - If.over$2500,a Notice of.Commencement is required. (A/C upgrades over$7500)
<br /> ' �� f..:; .,. ,,,.,.,� .
<br /> �� Agent(forUi'e�cont�actor)•orPower of Attomey(for tFie owne�)would'tie someone with notarized letter-from owner.authorizing same
<br /> ? `OVER�:THE COUNTER-�PERMIT.T,ING. ... (copyof.contract-.required) "" " " � -, `��`=��� ���� � � � �" ` �
<br /> � =Reroofs if'sfiingles Sewers.•-.�..���Service.Upgrades•A/C •-�Fepces(FIoUSurveylFootage) � '' " , _
<br /> .. _ _._. ._..._...:� .._ .- - - - -� ,• , , , , , ._ ;i_ ., _ , �. -..
<br /> _ 'Driveways-Not over Counter if:ori'�public,roadways'.needs,ROW; � - . . - _ .� ,� _.,.
<br /> ` , _ ,. , ' . , _, r
<br /> , h.�.. . ,.� i , � ' ir
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