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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Building Department
<br /> Date Received —� �
<br /> Phone Contact for Permitting � —
<br /> ��/ / � � � J�/�C
<br /> Owner's Name i�(��/ ll�/Yl c���pL� Z�' Owner Phone Number c��"'`� ""'7
<br /> Owner's Address � ( Z� 7 Owner Phone Number
<br /> Fee Slmple Titleholder Name Owner Phone Number
<br /> Fee Slmple Titleholder Address
<br /> JOB ADDRESS ��"�-� LOT# �
<br /> SUBDIVISION PARCEL iD#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � � N TALLSTR B REPAIR � SIGN Q Q DEMOLISH
<br /> I��
<br /> PROP..OSED USE SFR Q C011IIM 0 OTHER
<br /> TYPE'"OF CON$TRUCTION � BLOCK • Q FRAME STEEL Q
<br /> DESCRIPTION"OF WORK �w����� �'�'"" 3aX��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> OBUILDING $ ,-> VALUATIOfV'OF TOTAL CONSTRIJCTION
<br /> G
<br /> .-OELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING - $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � (
<br /> �3°�
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER l DO �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> �� [�(.�
<br /> BUILDER � COMP�4NY e��L��
<br /> SIGNATURE REGISTERED Y'/ N FEE CURRE� Y 7 N
<br /> Address �License#
<br /> ELECTRI,CIAN ; COMPANY
<br /> -SIGNi4TURE REGISTERED Y I N FEE CURREA Y/N.
<br /> " ..
<br /> Address - - License#
<br /> � F :+,
<br /> PLUMBER,_ CO�fIPANY
<br /> SIGNATURE REGISTERED Y•/'N .FEE CURRE� Y/N �
<br /> Address License#` :
<br /> MECHi4NICAL' � COMP,ANY
<br /> "`SIGNATURE''"� � � � REGISTERED , Y/ N. � FEE CURRE� Y/N I
<br /> � 3:: �
<br /> Add�e'ss�`� '� - ' License#
<br /> •:rir... � ..... . . .
<br /> ` OTHER` '��"'� ' COMPANY
<br /> ."SIGNATURE;3� ;;� .^ � - - REGISTERED Y/ N FEE CURREK , Y/N
<br /> _�,.. .. . " . ,.
<br /> ,.-, Address�.� �.- _ �� � .' ' Cicense#
<br /> �RESID,ENTIAL;�,-;� �•Attacfi;(2)�Plot':P.lan's;'(2)�sefs�of�Building�Plans;(1•)°set of�Ene�gy;For'riis;pR;0-1(V Permit,for new.construcUon,
<br /> ..�:.: . ,...:..,:. . .., .., , - . :
<br /> �-•`�y;"�,,�,�T;�;:--;Minimum�ten�(;10):inio.rking¢days�after subinittal:date:�.Required`onsite;`Con`struction Plans,`Storinwater Plans w/Silt Fence installed, I
<br /> .i;�. �� Saniha.ry.;tFacilities.,&,��1�dumpster;Site;Wo[k=Pennit for;subdivisions/large'p�ojects` _-. '
<br /> =���COh'IMERGIAL -Attach'(2)complete sets��of'Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for'new construction.
<br /> . Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> "` _ Santtary Facilitfes&1 dumpster._Site Work Permit.fo��all n'ew pFojects.AI�commercial requirements must meet compliance
<br /> '^�;SIGN-PERMIT 'Attaofi(2)sets'of,Engineered�Flans:+� -� � - �
<br /> - """PROPERl'Y SURVEY required for,.aII,NEW constructfon:
<br /> �.Di�ections: _ .-,.. ._ , _
<br /> -` F(Il:out�application completely.
<br /> , Owner&ConVactor sign 6ack of application,notarized
<br /> _- If over$2500,a Notice:of�Commencement Is required.,..(AIC upgrades over$7500) _ _
<br /> �.`:tt_ i 3.^' . ......:.
<br /> -� Agent'(foF'41i'e�conNactor)`or�.Power'of`Attomey(focthe owner)would be someone with notarized letter.from owner authorizing same -
<br /> r�;��OVER:THE'COUNTER;PERMI7'TING.__,. +..:(copy�of-contract�required)I"� `' ' -' , -' . - ;
<br /> :�,Reroofs.if sfiingles Sewers Service Upgrades A/C` ., ,•Fences(PIoUSuniey/Footage) : .
<br /> ,, _.. .,,.
<br /> . . ..- �----•.,_. ____........ ..... ..._..
<br /> ' . Driveways-Not over Counter if on public�roadways:.n'eeds ROW �
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