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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> �, ` • Building Department 1
<br /> �'
<br /> Date Received y.fJ,�' /7 Phone Contact for Permitting � �f�✓ ��� _ Lf�f �
<br /> Owner's Name �S�. �1 �11-�5 Owner Phone tdumber �fJ�`- 2�e.�'��Z�
<br /> Owner's Address SfJ� �� ��� Owner Phone Number ��� � �3� p���
<br /> Fee Simple Titleholder Name ��'�'�-``� Owner Phone Number
<br /> Fee Simple Titleholder Address 5��
<br /> JOB ADDRESS S��� � LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � NEw CONSTR B ADD7ALT Q SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP.,OSED USE Q SFR Q COMM 0 OTHER �t/(��
<br /> TYPE:`OF CONSTRUCTION Q BLOCK - Q FRAfVIE 0 STEEL Q
<br /> ,�
<br /> DESCRIPTION OF WORF( -ZNs I7n-�•L, Z 3�L�w ��' c�- � �}-Fj C�y�7���,���� w Z �,f'
<br /> 1
<br /> BUILDING SIZE SQ FOOTAGE . . HEIGHT •
<br /> OBUILDING $ ��3t cv VALUATION'OFTOTALCONSTRUCTION ��y3� �G
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �
<br /> � ��
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �
<br /> .. G�
<br /> Q,GAS Q ROOFING Q SPECIALTY 0 OTHER ,� 3 7 y 7
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ��gh�
<br /> ,�G�a0d �� ��
<br /> BUILDER ,, � CORAPANY �s� ��-'�
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA � Y/N
<br /> Address 2C{j/ /1f,. LF(>�" S�- %/d�1l�� �%C 33�� . -l.icense# ��-�U��1� �
<br /> ELECTRICIAN COMPANY '
<br /> SIGNATURE REGISTERED Y/ N FEE`CURRE� Y/N.
<br /> Address License# � �
<br /> P.LUMBER�; , COM PANY�
<br /> -SIGNATURE, REGISTERED Y•/ N FEE CURRE� Y/N
<br /> Address License# :
<br /> -�
<br /> `. -MECHANICAC �` � . COWIPANY
<br /> � SIGNATURE"' REGISTERED , Y/ N FEE,CURRE� - Y/N �
<br /> Add�e`ss'•� ' � ' �License.#; -
<br /> :�r:' . .
<br /> - OTHER�:` . �� COfVIPANY
<br /> ``SIGNA•l:URE-..i;:�� -� � � � Re��sTEReo . Y/ N FEECURREK Y./N ._.
<br /> - 'r;?.;�,r ,� � � �.�r , -. .. ' ' ,
<br /> - Address�s; , _ . - � License#
<br /> - a�;_,<,;-., ... ,
<br /> ��:`RESIDENTIAL.'_`�;.`Attach;:(2)';PIof:Plans;`(2)`�sefs of�Building=Plans;(1�)°set'of-Energy Forms;R=:O.-VN Pe'rmitfor new,construction,
<br /> ` ;�.� ,��-�� -�-�-: Minimum�;ten�(,10)workingidays:afte�sulirrtittal�date. Required'onsite;`Gon"str'uction Plans,�Stormwater�Plans w/Silt Fence installed,
<br /> �',v r r.:� , �.,,._ ._,.. . .. ..
<br /> .. .J./�kc'•.•'�:�..... . . .
<br /> �:-� � Sani4ary+;Facilitie,s-2&;1�xdumpster;Sife;Wor,1c,Perrnit.for�subdi'visionsllarge p�ojects'� _` -
<br /> ;;;�COMMERGIAL Attacfi�(2j�complefe'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 Eacilitles&1 dumpster..Site Work Permit fo�all-new p�ojects.All commercial requirements must meet compliance
<br /> $�:;.SIGN�PERMIT `Attach�(2)sets.ofiEngineered;Plans..rt ,< � • _
<br /> ""'PROPERTY SURVEY required for_aII.NEW construction. ,
<br /> ���Di.rections: .- _.. _ �
<br /> Fill<out application completely.
<br /> - Ouvne�'8•Contractorsign back of application,notarized
<br /> �lf over'$2500,a Notice.of Commencement is required. (A/C upgrades over$7500)
<br /> .`,:.::; •�..c; ..
<br /> Agent:(forthe�conuaator)�or Power of Attomey.:(for'tFie owner)uvould tie someone with notarized letter from owner authorizing same
<br /> �':.OVER:THE:COUNTER:PERMiITING_.... ;(copy..of-contraotrrequired) -
<br /> ;'_;Re�oofs if shingles Sewers Service Upgrades;A/C .Fences_(PIoUSurvey/Footage)
<br /> ' Driveways-Not over Counter if on public roaiiways..needs ROW �
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