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813-780-0020 City of Zephyrhills Permit Application F�-a�saeo-ooz�
<br /> :;� �' � ' Building Department
<br /> Date Recelved . Phone Contact for Permittin —
<br /> 9 _, .
<br /> Owner's Name i�� �d �� /l/ � Owner Phone Number ��� ������7 7�
<br /> Owner's Address �D a �� �/U� � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � �Z � �1/,e� r2 � 3 ��l Z LOT# �
<br /> SUBDIVISIOM PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED .. NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH
<br /> B INSTALL B REPAIR
<br /> PROPOSED USE Q SFR Q COMM Q OTHER `
<br /> TYPE`OF CONSTRUCTION Q BLOCK • Q FRAME � STEEL Q
<br /> s� �
<br /> DESCRIPTION"OF WORK ' � DN t/ O/��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> OBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> �QEI:ECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> �
<br /> QPLUMBING $
<br /> QMECHANICAL $ � �->D� VALUATION OF MECHANICAL INSTALLATION
<br /> d
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -.BUILDER - COMPANY
<br /> 81GNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address -License,# �
<br /> ELEC,TRICIAM COMPANY
<br /> - SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address License# �
<br /> PLUM�E,R;,, COMPANY
<br /> SIGNATURE REG�STeREo Y�/ N� ` FEE CURREA Y/N
<br /> Address License# i
<br /> - , .�, i
<br /> , MECHANICAL' �/� � / �/� COMPANY •% �'�`��S ��C/� I
<br /> ""`SIGNATURE'� � �/ v"�v �/' U r�"v REGISTERED - , Y/ N FEE CURRE� , Y/N � - �I
<br /> ABdress�` , � l d ��'��,K C _ Ucense.# ��� l � S�
<br /> �r;iy'-, s-•- ' 7 '
<br /> , �� , � , G 3 r� �
<br /> .`.,OTHER�''";`"fi , - " COMPANY '
<br /> S5'-SIGNATURE=����z= .�� - ' • ' - REGISTERED Y/ N . FEE CURREK Y/N
<br /> ' •,,. � _ , . � . -
<br /> �� Add�ess{�. •�• - - - '- ' License#
<br /> `*;{,r
<br /> `�-;RESIDENTIAI:'t,•`` :AttacFir(2)':PIot:Plans;?(2�)'setsof�Building�Plans;(1•)°set`of�Energy;Foiiris;R=O=T(V.Per'rtiit,fornew,constryction,�
<br /> _ _ :•�'+,ra'*,:��:;;�;-�Minimum;ten,(s1Q),working�:days;afte��submittal:date.F�Required`orisite;='Constr'iiction Plans,�Storinwater P�lans w/Silt Fence installed,
<br /> ��-�;~, �„� '�h� Sanitary•Fac111Ges;,8�a1�;dumpster Site�WorlePermitfor.;subdivisions/large';projects` '� '' �
<br /> '<`COMMERCIAL Attacti�'(2)'complefe sets of�Building�Plans`plus a L'ife 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 /> �� Sanitary Eacilities 8�1 dumpster.Site Work Permit fo��all•new projects.All commercial requirements must meet compliance
<br /> ::SIGN;PERMIT �AttacFi(2)sefs,-of,Engineered.Plans:��� . � _-. -. _ , .
<br /> ��`-�� """PROPERTY SURVEY r ,uired for,all.NEW I
<br /> ,;= - . .....p..�_.....eQ.__. constructlon:- . , .
<br /> =Dicecttons: _.., .-_..-.:- ,. �
<br /> � �F �Fill:'outapplication completely. '
<br /> ' Owner'&Contradtor sign.tiack of application,notarized
<br /> if over$2500,a Notice.of:Commencement ts required. (AIC upgrades over$7500)
<br /> � �_r..�;.....;;<�.,
<br /> "'";,. Agent(forth'e�oont�aotor)`orPower'of'Attomey(for'tlie oiivner)would 6e someone with notarized letter ftom owner authorizing same
<br /> ;�:�; .:.,. . .
<br /> :;�OVER.THE�CO,UN7°ER�PERMI7TING:.. .- ..(copy�of-contract-.required) � ' ''
<br /> '""Reroofs ff'shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> :. � _..__,._ , .
<br /> _.... _ �.---,_... ---.�_.. .... : ,
<br /> �tJ..,
<br /> , " Drlveways-Not over Counter if on public roadweys..needs ROW
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