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<br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> .r== ': ; Building Department
<br /> Date Received Phone Contact for Permitting , -
<br /> Owner's Name � C�R.. Owner Phone Number
<br /> Owner's Address Owner Phone Number
<br /> Fee Simple Titleholder Name ' Owner Phone Number
<br /> Fee Slmple Titleholder Address
<br /> �
<br /> JOB ADDRESS D 3 ,5 .e 3 /D L ✓� U� LOT# �
<br /> SUBDIVISION PARCEL iD# I�'2� �1��Q- OD �''�OIJ
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B .. NEW CONSTR B ADD/ALT Q SIGiV Q Q DEMOLISH
<br /> INSTALL REPAIR
<br /> PROP..OSED USE - Q SFR � COMM 0 OTHER '
<br /> TYPE'"OF CONSTRUCTION Q BLOCK • Q FRi4ME. 0_ STEEL Q
<br /> . t� / `
<br /> DESCRIPTION OF WORK y' /S�f� C,v �Q ,C(f K �P (' d�f- ��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ VALUATION'OF TOTAL CONSTRUCTION
<br /> �'�ttlt-��
<br /> �LECTRICAL $ ��U-� c AMP SERVICE,�QD Q�Pf�OGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBIfVG - $
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ,� /�,�
<br /> G I,�✓ /�
<br /> / � �
<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> -.BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N
<br /> Address "License# _
<br /> ELECTRI,CIAN : � COMPANY �� /`�(�/PC (� d` ��. CG� �Y�' L��
<br /> - SIGNATURE � REGISTERED Y/ N �FEE CURRE� Y/N.
<br /> h-� , t /
<br /> � Address �� � /�c License# �.'��(�O� �Z�P ,
<br /> Y . . . �
<br /> P.LUMBER.,, COIMPANY
<br /> 'SIGNATURE <REGISTERED Y�/ N , FEE CURRE� Y/N
<br /> Address L(cense#-
<br /> MECHi4NICAL COMPANY •
<br /> " SIGNATURE•'' � REGISTERED Y/ N FEE CURRE� , Y/N '
<br /> Add�ess�� ` - License.#
<br /> ,s,�i�, , ... , '
<br /> ` OTHER:>.:``'=: • ,; . ' ` C,OAAPANY
<br /> '<�SIGNATURE:i���:=*: :�� _ �- " REGI3TERED Y/ N FEE CURREK , Y/N
<br /> . ,�:;:;�. , . , .. . . . '
<br /> Address��_ - - - - •• • " '
<br /> _. , License#
<br /> ;�;:
<br /> _r.= _. . , � ,:�::'-_• `�M;. � � •' �� . ,
<br /> , � . . , ...._,. ;:.,< ,.. . ,,,.;, , . .
<br /> ' _�RESID,ENTIAL�� "Attach;(2):Plot':P.laris;'(2•)�sets of',Building�Rlan§;(1)'sefof�Ene�gy,Forms;R;O-T(V PeRnitfor new.construcUon, �
<br /> :_ -M:�<•;;.:,.::c-�.Minimumaten�(10).working;iiays:after'sutimittal:date.:Required onsite;rtCon`striiction Plans Stormvirater Pl,a'ns w/Silt Fence installed,
<br /> ,, : ,��.,�.:4..,,. .�• �,,...,,..,.
<br /> - Sanita.ry,,Facilities:;&=�1,;dumpster;�Site;Wor,k Permit�foe;subdivisions/large;projects' •" ' �" ` ' �
<br /> -;:COMMERCIi4L Attach�(2)�complete�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(70)working days after submittal.date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> - ' Santtary Facilittes&1 dumpster.Slte Wo[k Permit fo�'all new projects.All commercial requirements.must meet compliance
<br /> !��_$IGN;PERMIT �`AtfaoFi(2)sefs:,of;Engineer'ed'Plans.�s.� :�;�� - � � �� .
<br /> "•"PROPERTY SURVEY required for..aII.NEW construction.-
<br /> ��Di�ections: :r•=.s:;_.,_.- =:,; .
<br /> 'Fill:out:application completely.
<br /> - Owner&ConVactorsign back of applfcation,notarized
<br /> ' °I�f oVer.:$2500;a Notice of.Commencement-Is required. (AIC upgrades over$7500)
<br /> '^`:fll-' l.=t.::ti.�-...i':�.4
<br /> , AgenY(fo��the>contractor)�or°Power'of.`Attomey(for'the ovirner)would tie someone with notarized letter from owner authorizing same
<br /> ;;'OVER:THE COUN7'ER�P„ERMIITING; (copy_of-contract<required) - - �
<br /> `=>�Re�oofs.if'sFiingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> Drtveways-Not over Counter if on;public roadways.:needs"ROW �
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