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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �,�;',;,r :�� � Building Department ,
<br /> . y- 7-�7
<br /> Date Received Phone Contact for Permitting �� — �b�.�
<br /> Owner's Name �" ��'//�l2 f� Owner Phone Number U �✓� r �� '
<br /> Owner's Address �b /�J �d �`�7��s ���� Owner Phone Number
<br /> Fee Simple Titleholder ldame Owner Phone Number
<br /> Fee Simple Titleholder Address -
<br /> JOB ADDRESS 3�.'J��l� e j,{)� LDD LOT# �
<br /> SUBDIVISION PARCEL ID# �� �� �� 0��� d��D lG/��
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH
<br /> e INSTALL REPAIR
<br /> PROP.OSED USE Q SFR Q COMM 0 OTHER
<br /> TYPE'OF CONSTRUCTIOId Q BLOCK • Q FRAME � STEEL Q
<br /> DESCRIPTIOM OF WORK �Si �G � IC} � L��DL( � TDI�.S �/�� P�eL�� (,L/rj.
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> �MECHANICAL� $ /_�� Da VALUATION OF MECHANICAL INSTALLATION
<br /> Co
<br /> QGAS Q ROOFING Q SPECIALTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address �License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N � FEE CURRE� Y/N
<br /> Address � Cicense# +
<br /> PLUMBER.. COMPANY
<br /> SIGNATURE REGISTERED Y/ N ' FEE CURRE� Y 7 N
<br /> , Address ' License#=
<br /> MECHANICAL ��� � � COMPANY ��,7-rif2�j g/�L S 't �C �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE�- � Y/N
<br /> Address � / lTI�eA� 1CGY —HILLS Licens.e# C/T�D �� ��
<br /> OTHER�� ''' COAAPANY
<br /> SIGNATURE.: '•` - REGISTERED Y/.N , FEE CURRE�' , Y/N
<br /> Address . • � License#
<br /> 'RESIDENTIAL' � Attach(2)Plot P_lans;(2)sets of Building�Plans,'(1)�set'ofEnergy Forms;R,O-W Pemiit.for new construction, �
<br /> - � Minimum ten.(10).working,days aftersubrriittal-date. "Requfrecf onsite;Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> � Sanitary Facilities,&�1�..dumpster Site Work Permit for subdivlsions/large projects �
<br /> COMMERCIAL Attach�(2)complete'sets of Building Plans�plus a Cife Safety Page;(1)set of Energy Forms.R-O-W Permitfor new construcUon. �
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence•installed,
<br /> � Sanitary Facilities&1 dumpster.Site Work Permit foFall new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT i4ttach(2)sets of�Engineered Plans. �
<br /> , '""*PROPERTY SURVEY required for aII.NEW.construc6on.
<br /> DiPections: . , - �
<br /> - Fiil out application completely.
<br /> , �Owner&ConUactor sign.back of application,notarized
<br /> If over$2500,a Notice of Commencement Is required. (A/C upgrades over$7500) '
<br /> " Agent(fo�4he�conuactor)orPower of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER TME COUNTEI�;P�RMI�TTtI!fG";�'"';.t(cdpy=of so"htr�et�t`equired) .r.i35S�;��at.;� �.".ilC.v;; .,,•,,,, �
<br /> Reroofs if shin les ``Sewers ' Seriiic"e�U rades�A/C Fences(PIot/Survey/Footag � � ,, , �'� ''4i�<;,,
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