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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Building Department
<br /> i,r .
<br /> Date Received �
<br /> Phone Contact for Permitting � —
<br /> Owner's Name P� O G U� Owner Phone Number 3�Z— �Z�—�S�S
<br /> S3.j S" ,5"�
<br /> Owner's Address S� Owner Phone Namber
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS ���-� r�� S LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B . NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH
<br /> INSTALL REPAIR
<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
<br /> � `� I/�' FC� c�. �7� �
<br /> BUILDING SIZE �Q FOOTAGE - I 73 HEIGHT � �
<br />, QBUILDING $ Z y�Ur O v VALUATION'OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R:E.C.
<br /> QPLUMBING $ , ���
<br /> � L
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> ?�7s
<br /> Q,GAS Q ROOFING Q SPECIALTY 0 OTHER i
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO �
<br /> BUILDER COMPANY �P ���GJ
<br /> SIGNATURE �'� REGISTERED Y/ N FEE CURRE� Y 7 N
<br /> Address "License#
<br /> � 'ELECTRICIAN , COMPANY
<br /> SIGNATURE REGISTERED Y/ N �FEE CURRE� Y/N.
<br /> � Address License# ��
<br /> .�, -
<br /> PCUMBER.;. COMPANY�
<br /> SIGNATURE � _ �RE��s7EReo Y•/ N FEE CURRE� Y/N
<br /> Address License# '
<br /> - MECHANICAL" � COMPANY
<br /> "' SIGNATURE'"` � � REGISTERED Y/ N.. FEE CURRE�� , . Y/N .
<br /> 3, r
<br /> Add�e`ss�` � � Licens.e#
<br /> ..:F.. ..., _ -
<br /> ,- OTHER�"'.s`. �• ' COMPANY
<br /> s..J'SIGNAT:URE'r;..,:=. - REGISTERED . Y/ N. FEE CURRE� Y/N
<br /> _ Address,.�. � ;::Y ,. . - ' Cicense#
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<br /> :�-'RESIDENTIAL'.;��� Attacti{2),PIot:P.lans:'(2)�sets-of�Building=Flans;r(1�)=set of Energy�Forms;R=O=W Permit.for new.construction, �
<br /> " _ � �--•� ^:-•: Minimum:ten;(10,)working;daysafte�`submittal<date.'Required�onsite;ConsWction�Plans;Stormwater�Plans w/Silt Fence installed,
<br /> :,: -.e..=:'s.;,_;.;.. _ ,. .-_- : . .,
<br /> ._- Sanitary;Facil(ties:;8�t1,,dumpste.r•,�Site;,,W..orkRermitfor'subdivisions/large'projects ' -
<br /> �. .,.._ ..
<br /> ;��COfVIMERCIAL Attecli{2)complete sets`of"Builiiing Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
<br /> 'n,.
<br /> � ' Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> _ - Sanitary Facilities 8�1 dumpsterm_Site Work Permit"fo�-all•new projects.All commercial requirements must meet compliance
<br /> ,;,SIGN'.PERMIT 'Attacfi(2)sets;of;Engineered:Flans:,r .��, _ -
<br /> •'•"PROPERTY SURVEY required for._aII,NEW construction.
<br /> ;DlrecUons: r�,.-, _ .� ,
<br /> � Fill-:out�applica6on completely.
<br /> Owner'8�Contraotorsign.back of appBcation,notarized
<br /> �If over$2500,a Notice�of:Commencement is required. (AIC upgrades over$7500) .
<br /> �}".ff�i 'li :i.,�li
<br /> , .AgenY(for th'e�cont'ractor)or°Power of Attomey'(for'ttie ouvner)would tie someone with notarized letter from owner authorizing same
<br /> s;;OVER.THE'COUN'TER:PERMI]TING. (copy,of_contractrequired) - '
<br /> ��:Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter'if on public roadways..needs ROW
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