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813-780-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � � Building Department .
<br /> Date Recalved l_ � . � phone=Contact forPermittln - —
<br /> Owner's Name �cl/� � I�,qr✓�/"L/��1J/1J Owner Phone Number �° 2'�6� 6 2 ��
<br /> Owner's Address �� �` � �'� � Owner Phone Number
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<br /> Fee Simple Titleholder-Name Oweer Phone Number
<br /> Fee Simple Tltleholder Address
<br /> JOB ADDRESS J,� � �T�---� ' LOT# �
<br /> SUBDIVISION PARCEL ID#
<br /> • , (OBTAINED FROM PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED �,�NEW CONSTR ADD/AL-T � Q SIGN Q Q DEMOLISH
<br /> � .e._ INSTALL B • REPAIR •
<br /> PROPOSED<USE Q SFR Q COMM • " Q •OTHER ' �
<br /> TYPE OF CONSTRUCTION �� Q� � BLOCK " Q FRAME Q STEEC Q
<br /> DESCRIPTION OF WORK �L',v� G��,g � �v� Z--,� i 6'� l ����
<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 /> QPLUMBING $ -
<br /> QMECHANIGAL ' $ a�� � VALUATION OF MECHANICP�L INSTALLATION
<br /> QGP�S Q ROOFING .Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �NO
<br /> BUILDER COMPANY
<br /> SIGNp►TURE REGISTERED Y/ N FEE CURRE� Y/N .
<br /> Address ' � Lfcense# '
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<br /> ELECTRICIAN� , - � COMPANY • �
<br /> SIGNATURE � REGISTERED Y/ N PEE CURREK`' = 'Y/N
<br /> � .
<br /> Addre�s � :� Ucense#. -�
<br /> PLUMBER ' , ,COAAPANY _• - - �
<br /> SIGNATURE' ' , _REGIST.ERED, Y/>N,. : FEE CURRE� . ' Y�/N.
<br /> Addre�s � �Ltcense,# � .. �,. �: - _ -
<br /> MECHAfVICAI:` �/+�"�"'�f e2r� •�`` . COMPI4NY, �. -�'►� �� A'lC • .
<br /> SIGNATURE• � REGISTERED Y,/ N , FEECURRE� Y•,/,N'. : -
<br /> Address� , . . , � - ' , • ' License#�
<br /> :x,.. , . . . . _ . . , -.,
<br /> , , . � ,
<br /> OTHER � ' � � � ;COMPANY. � ��
<br /> - ., „ � ... ,.. . .
<br /> SIGNATURE '�:t :' :'> ""•� °^''``° "` � � � " REGISTERED` Y/ N .. ��FEE CURREA Y/N
<br /> Address N . �s. ' . ; . �Gcense#' ' . , �
<br /> �,_... .. . �
<br /> RESIDENTIAL:,'-:;:.°AttactY(2)�PIot�Plaris;.:(2)sefs"�of:Buil8ingi'Plans;'(1)sefof'EnergyYFoiins;'�R=0=1N�Perrriif for new construcUon, '
<br /> -:, ��_�;�.�aMinimum4ten;(•10)wrorlcing;days`after;§ubmittal'date.�.Requlred onsite,tConstnic8on'Rlans;�Stormwater.'Plans�w/Slit'Fence ins�lled,'
<br /> � �Sani'ta'ryFacillUes,8��1�,dumpster�Site•Woric�Permif_for:su6divislons/large:proJeots" _-"._�� ' - �
<br /> COMMERCIAL Attach(3)`cornplete sets-�oYBuildlrig Plans plus,a Life'Safety Page;(1)set of Energy Forms.R-O-W Pertnit for neW construcUon.
<br /> Minimum ten(10)working_days after submittal date. Requfred onsfte,Constructlon Pians,Stormwater Plans w/Sflt Fence tnstalled,
<br /> Sanitary Facilides 8�1 dumpster.Site Work Perrnit for all new�projects:.Ali commercial requlrements_must meet compllance
<br /> SIGN PERAl11T Attach"(2)sets of�EngineeredLRians:;, - ��'`� _ � ,- `
<br /> ""'PROPER7'Y SURVEY reyuired;for all_NEW construction.�
<br /> _.___._,. -... - ,,
<br /> Dlrectlons: - .. • � � � - '
<br /> Fill out applicadon completely.
<br /> Owner&Contractor sign back of applicatlon,notarized �
<br /> If over 52500,a Notice of Commencement i�required. (A!C upgrades over ST500) .
<br /> :�•._.,._.;,.:ti.aa,,:.�
<br /> '* Agent(for the contractor)''or`Powe�of Attomey(fo�ttie owner)would be�someone with notarized letter from owner authorizing same
<br /> DVER THE COUNTER:.P.ERMITTING--- ----(Front of-Applicatlon�Onty)
<br /> Reroofs if shingles � Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) _
<br /> .. _"_ .�. ....... �. . ., .. . .-..v -..2s .�....� . ..:-_' . �..rriz..`J.ma.� a..�.rt ....iLti �.il�.�_.�.. ' `_"
<br /> Drivewaya-Not over Counter if�on publlc.roeduvays.;n.eeds�ROW.• : ___�=-��, ,_,-�;^ �- - ,,; .
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