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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> • Building Department
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<br /> Date Received .. phone Contact for Permittin -
<br /> g.:.
<br /> Owner's Name C_ p �� 2 �� Owner Phone Number f��,5�-r T/ '�,O %
<br /> Owner's Address l0�.� ,Z� s� Z'� /r (l�/�!1/ Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Addcess
<br /> JOB ADDRESS J�r/►,r LOT# �
<br /> SUBDIVISION � PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED .. NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> B INSTALL EP I ,
<br /> PROP.,OSED USE Q SFR COMM � OTHER —
<br /> TYPE`OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q
<br /> w�
<br /> DESCRIPTION OF WORK L� S �� L �
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT �
<br /> QBUILDING $ ��--� � VALUATIOtV'OF TOTAL CONSTRIJCTION
<br /> .
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> �GAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER � COMPANY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address 6(S/ �%� License#
<br /> 'ELECTRI,CIAN COMPANY�
<br /> _ SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address` - License# �
<br /> 1. '�.r
<br /> PCIiMBER.; COMPANY
<br /> -'SIGNATURE REGISTERED Y�/. N� ` FEE CURRE� Y/N
<br /> Address. � License#' .
<br /> - .MECHANICAC COMPANY
<br /> "'SIGNATURE" REGISTERED , Y/ N , FEE CURRE� Y/N �
<br /> Add�ess��' ` � License.#
<br /> ;.�;;,. , . . . ,
<br /> OTHER".�^` ` - ' � COMPANY
<br /> -° SIGNATURE�> >� - Re��sTErteo Y/N FEE CURREK Y/N
<br /> �;, �.�;. � , .
<br /> Address� � - - � • - '� ' License#
<br /> �:.a:,, <.,.. . , _
<br /> '�"�;RESIDENTIAL�,�•`;`Attacli�;(2):;PIot=P.lans;`(2).setsof`Building�Rlans;(1�)`set'of�Energy,For'riis;B'=O;W Permitfornew,construction,
<br /> �4�<�,�r,s�.,�--,:Minimumr:ten;;(1Q);workingzdays'afte�,§utiinittal�iiate.�Required onsite;Con"struction Plans,"Stormwater'Plans w/Silt Fence installed,
<br /> `'` � � Sanitary,F�acilities;8�;�1.,dumpster_Sife;Work Permitfor:;subdivisions/large'projects� '-' � � -
<br /> �1�:GOMMERCIAL Attach(2)complete`sets`of Building Plans plus a Life Safery Page;(1)set of Ene�gy Forms.R-O-W Pertnif for new construction.
<br /> - ' - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 8:1 dumpster.,Site Wor�C Permiffo�all new-projects.All commercial requirements,must meet compliance
<br /> r'..:$IGN`PERMIT �Attach(2)'sets of,Engineered"Plans:�: �= • �
<br /> •"""PROPERTY SURVEY required for.all;NEW construction.. .
<br /> -C;�'�- �
<br /> ;Di�ections: tt ,..., .. -, ,.
<br /> .�' -�Fill<out application completely.
<br /> -Owner:&Contra�tor sign back of appllcation,notarized
<br /> , if oven$2500,a Notice•of Commencement is requlred. (AIC upgrades over$7500) ,
<br /> .,..;- ..
<br /> ;" AgenY(for�th{e�conVactor)orPowerof`Attomey(for'tFie ovirner)would be someone with notarized letter from owner authorizing same
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<br /> , -_ .
<br /> -;: •:;
<br /> �;OVER.THE COUNTER�PERMIT,TING, .:- (copy of-contract-required) �
<br /> "�Reroofs�if sfiingles Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage) � .
<br /> � Driveways-Not over Counter if on-publidroadways.:n'eeds.ROW=.:.. �- _-- .. ., .,�-__ n -� ."-"":_.-�---"�--_.
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