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813-780•0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ,;R:� ; •• Building Department
<br /> Date Received �- �. / phone Contact for Permittin � ,r - � � �
<br /> 9 -:
<br /> Owner's Name Owner Phone Number ��� ' O �
<br /> Owner's Address � ��Qr� Owner Phone Number
<br /> Fee Simple Titleholder Name Owiner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION /' ' �r'i PARCEL ID# o% Q QQQ�� a�o�c�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B � NSTALLSTR 8 REPAIR � SIGN Q � Q DEMOLISH
<br /> PROP..OSED USE Q SFR Q COMM Q OTHER .
<br /> TYPE':OF CONSTRUCTION Q BLOCK •• Q FRAME Q STEEL Q
<br /> DESCRIPTION OF WORK C 1�J� (i /�7-/� � �
<br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT
<br /> .i
<br /> QBUILDING $ VALUATIOIV'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $
<br /> MECHANICAL $�J � VALUATION OF MECHANICAL INSTALLATION /�3�
<br /> 7 li �
<br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER �(Y �� �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br />- BUILDER - . _ - -- - --COMPAIdY - - -- - ----_----- -- - - - - -- ---
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N ,
<br /> Address License#
<br /> ,. _ .
<br /> ELECTRICIAN .: COMPANY�
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
<br /> Address - - License# �
<br /> �� r,c.�;.. : _ _ " - _ .. , ' .
<br /> PLUMBER.;,_.- COMPANY�; ' , . ' .
<br /> SIGNA�TURE � - •REGISTERED Y-/�N:` ` > "," FEE CURRE� � Y/N
<br /> Address License# ,
<br /> '.MECHAfdICAL.' ' ` , COMPANY . �" � �
<br /> I''SIGNATURE'" � �� � REGISTERED N �! _FEECURRE� . . .,Y -N .' r � •
<br /> Ad'd�ess.° �- � � 0�' /✓• L:icense# �(.._ Q ��� � -
<br /> ,;_;�'...f� ` � _ , _ . � r " .
<br /> :-�OTHER" . _ '. ' ' ` , '- - 'COMPANY - ,
<br /> :�: SIGNAT,URE�:+ c' -- ,� '� '� � REGIBTERED Y/ N, � FEE�CURREK Y/N • ,
<br /> , , S.' ' .. . . , , .
<br /> �it.�i•'+:•��,:. .^' r ' . . � . . . .. _
<br /> ;Addr`e'ss;�;': ;y = ' Gicense# - - `- rv . ,
<br /> � - - -
<br /> ':,_'r x:-%' -- - • . . .�. - �
<br /> �,RESIDEPITIAL;:,� AttacFi;'(2)':Ploti'P>lans;';(2):sefsof�Bu'ifding`Plans;(1)`setofEnergyForrtis;R=0-V11=;Pemiit,fornew.construction;� -
<br /> - - -.. ��:�;;,.;,��-�-�;Minlmum',ten,�(;1_0);wo,rking�days after'.su6mittal:dafe:-:Required_onsite;`Construction`Plans;Stormwater Plans w/Silt Eence�.installed, .
<br /> "' .�+ .. . .� ' .< •,f . .
<br /> ���"` � 4.� � '�� Sanita.ry,Facilities&N1,dumpste,r-,_Site;Wo[klRermitfor.''§ubdiyisions/large;p�ojects :. �� �- • " ; •' ���- � � -� -
<br /> ,;:�:.:' - ���.��: _
<br /> . _ . ..,�......_�_ � ,
<br /> _ .. . -
<br /> ;:_�COMMERCIAL,... Attach`;(2)�complete.sefs.;of=Builiiing:Plans,plus a•L:ife Safety Page;.(1)set-of Energy FormsrR-0=W P.ermif for•new constiucUon.,,�
<br /> =` `"' � '��.Mlnimum:.ten: 1.0':workln rda:s;after;submittal�date: Re uiredonsite,ConstrucNon:Plans;:StormwaterRlansw/,SiltEence:installed,_ � �,-.
<br /> : � .)... ... 9 Y 9 ;: .
<br /> '" � �•�' '`'��`�- ��'� � '� �Sanitary,EaciliNes"&''1�'durimpste�:_8ite:Work F,ermit:fo��all=new;projects.All;commeraial:requi�ements;must`me'etcompliance. '
<br /> �?�.. �. .:: _ .,.,;.,.,,>- � - . _ , , , . � .
<br /> ,!:;SIGN:PERMIT" -- "Atfacfi'"(2)'sets of;Engineered P.lans:���•_.���,� � - - ' • , � ,
<br /> - � """PROPERTY SURVEY;re ui�ed for aII�.NEW,construction.: , . '_ - � . .
<br /> _ ,4. . ._ . . ,
<br /> <;-Directionsr � - _ . .. . .. . - - - - ,
<br /> ,_ _ '1,_
<br /> �`� `:� �Fill�out applicaflon;dompletely.��_ - �."',;, .:' ,_:. .;,
<br /> , •O.wne�.�Cantracto�sign;6ack.of.applicatiori,;notaFized- - � - .
<br /> , �'If,o'ver�$2500,a Notice'of:Commencement;ls=required.,,_(A/C•upgrades:over$7500)�, -_, - ,
<br /> ��''"� A ent,fo�th`e�cont�actoc°orPower�ofAttome;(for'fFie;oiivner would'tie��'someone witFi':notarized letter from owner authoriiin :same
<br /> 9 � ) Y )- - 9
<br /> ;;�OVER:�..T.HE'COUNTER;PERMITTING'._" .;:.'���(copy.of�contracf:required)� :,''�` " , � � ` '
<br /> "'s�Reroofsif�shingles� � � Sewers � ;Seniice Upgrades.AIC'; Fences(Plot/Survey/Footage) , -
<br /> = ,.. ' ''; �,.. -_ , :__. �,�.-:�'�;._;..�. :,�.�.. _,,..,.;.:- :.,,,'... :- , -_ ` _ , �
<br /> _ ., �.Drlvewrays=Not over Countee;if.on:pulilic'.roadways..'nee8s'ROW�" � ' � '
<br /> _ "',;,• , , ,. ' , , , , .,
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