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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � Building Department
<br /> Date Received,
<br /> Phone Contact for Permitting ; _
<br /> Owner's Name '�)� �J 1��-l��.� Owner Phone Number �t 7 7"5
<br /> Owner's Address ` �� � LQ " � Owner Phone Number , ���- ✓� a
<br /> Fee S1mple Titleholder Name Owner Phone Number �� a�r�i-g o0
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �Ct-`��- �--� �-�V�v��- LOT# �
<br /> SUBDIVISION ( � l L1 ' PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED e � NSTALLSTR 8 -REPA RT Q SIGN Q � Q DEMOLISH
<br /> � PROP.,OSED USE Q SFR Q COMIVI 0 OTHER
<br /> TYPE'OF CONSTR'l1CTION Q BLOCK • Q FRAME 0 STEEL Q I
<br /> ' tiq
<br /> DESCRIPTIOM"OF WORK �Yl�f'o� Yl C •� �,,i c� . � {�j �\�pCJ-y� �-�-�L�-� �'��
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ �b �� � VALUATION'OF TOTAL CONSTRUCTION
<br /> •_QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> OPLUMBING $ � /�OC
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION D ���/��;�� �C
<br /> Q,GAS Q ROOFING Q SPECIALTY Q OTHER (f/
<br />� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO C �� ,
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<br /> � 1 �,�
<br /> BUILDER � �COMPANY ��aL��"�,
<br /> SIGNATURE � ���-/�� ��� REGISTERED Y`/ N FEE CURRE� Y/N
<br /> Address �jG-'�-�2. �S ��p�� -License.# �
<br /> - ,�
<br /> ,- 'ELECTRI,CIAN ,,, g �/�i � COMPANY
<br /> SIGNATURE - �� REGISTERED Y/ N �FEE CURRE� Y/N.
<br /> ' Address - License# �" �
<br /> P.CUMBE�;::: � �OMPANY- .
<br /> 'SIGNATURE REGISTERED Y-/`N . FEE CURRE� Y/N I
<br /> Address , License# :
<br /> �'MECHi4NICAL' ,6 COMPANY
<br /> " SIGNATURE' " � ��
<br /> REGISTERED , Y/ N, . FeE CURREn , Y/N ,
<br /> Add�e"ss�•` - •• Licens.e.#
<br /> �:tk�'. _ ' .,. -.. . . _ .
<br /> :: OTHER` ��, , , ` , ' COMPANY � �
<br /> ;"=SIGNATURE,�=•=:._ ^ ' -� • REGISTERED Y/.N FEE CURREK Y/N
<br /> ` Address�- " License#
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<br /> �;.-.:. ... .. . . :•, . .. ,v., ... . _ -,..,r,.: ; , .-m, • . : �
<br /> ;>.�RESIDENTIiAL�;�::':Attach'(2)`.Plot`:P.lans;'(2•):sets<ofBuililing�Plans;(1)=sefofEnergy'For'ms;R=0=Y11.Permit,fornew.construction, �
<br /> _ ;�•,.�';-�;.�:,•,.<:-_,:Minimum.�ten;(}1'0),wor.king;:days:aftersukimittal:date:�Required`onsite;Gonstruction Plans,Storinuirater�Plans w/Silt Fence installed,
<br /> =...- �Sanitary;FaGli6es;&r�ls;dumpster;_Site.WorkPermitfor;subdivisions/large:projects " `� ' �
<br /> `<COMMERCIAL Attach1(2)�complete"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 /> - San(tary Facilitles 8�1 dumpster,Site Work Permit"fo��all new p�ojects.All commercial requirements must meet compliance
<br />, `:�SIGN�PERMIT "Attacti`(2)sets;�of-,EnglneeredrFlans:=��� -�:�� � ' � • ,
<br /> *"""PROPERTY SURVEY required for all NEW construction.
<br /> ,..Di�ecttoris: ,=_K ..-.. .., ,.
<br /> -�' flll.out application completely.
<br /> Ouvner&-Contractor sign back of appllcation,notarized
<br /> °If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
<br /> ""'� AgenY(fo�'4h'e�contractor)°or°Power�of'Attomey(for'tF9e owner)would tie someone with notarized letter from owner authorizing same
<br /> .1:.
<br /> �?;OVER':THE COUNTER'rPERMIITING.�„_ (copy..of-contract-.required) '' ' - �
<br /> :-';Re�oofs if'shfngles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
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<br /> �., _._. _ _....�._....._._,...._._......_..__
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<br /> Dr(vewrays-Not over Counter if on public'roadways::needs'ROW �
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