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n,s-r�u-uuzu City of Zephyrhills Permit Application Fax 813-780-0021 �,
<br /> ; g� Building Department ' �
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<br /> Date Receiv�d ' ..� Phone>Contact for�Permitttn - ,
<br /> Owner'a Name n � � Owner Phone Number �
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<br /> Owner's Address Owoer Phone Number r
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<br /> Fee Simple Tltleholder.Name Owner Phone Number
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<br /> Fee Stmpla TIlleholder Address
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<br /> JOB ADDRESS �� ��! �G� �(� � LOT# � �� (
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<br /> SUBDIVISION PARCEL.ID# � � �
<br /> . „ _ (OBTAINED FROM PROPERTY,TAX NOTICE) I p
<br /> WORK PROPOSED :NEW CONSTR ADD/ACT � Q SIGN Q Q DEMOLISH � �
<br /> �•-B, INSTALL 8� -:-REPAIR - I :
<br /> PROPOSED�USE Q SFR• � COMM ° Q OTHER �� `
<br /> TYPE OF CONSTRUCTION < Q "BLOCK " Q FRAME . Q STEEL � �i
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<br /> DESCRIPTION OF WORK �
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<br /> BUILDING SIZE ' �'S6l FOOTAGE ' , ,HEI,GHT��, �� i
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<br /> QBUILDING $ VALUATION OFTOTAL-CONSTRUCTION" a :
<br /> QELECTRICAL $ " AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. j
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<br /> OPLOMBING $ - i �
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<br /> MECHANICAL $ 1� VALOATION OF.MECHANICAL INSTALLA7'ION � ;
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<br /> QGAS Q ROOFING .0 SPECIALTY Q OTHER i j
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO �' I
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<br /> BUILDER COMPANY'
<br /> SIGNATURE REGISTERED Y/ N '�E CURRen ' Y/N ',
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<br /> Address ' � License# ' '• !
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<br /> ELECTRICIAN> , • COMPANY � � '
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�' ' �"Y/N � !
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<br /> Address , - License#. � i ,
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<br /> PLUMBER ` COMP..,ANY - . �I '
<br /> SIGNATURE' " , _REGIS.TERED, - Y.l�N-. : --FEE CURRE� Y-/N. �
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<br /> Addre�s Ucense# 4 . � - �
<br /> MECHANICAL' COMPANY, � ' .��� . � �
<br /> SI(3NATURE ' ` REGIS7ERED : Y./ N . FEE CURR _ Y./�N =
<br /> Address" t � � License# D�� `� !
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<br /> OTHER i � ' - ' � '� , -,COI�APANY �'� �, , I
<br /> SIGNATURE �'�"' • "- ` - '� � REGISTERED Y/ N:.; FEE CURRE� - Y 7 N.
<br /> Addres�, - ^ `, - _ � . � Llcense#�� � �,
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<br /> RESIDENIIAL;;�'` ;Attacli"'(2)�PIot;P,.laes;�(2)sets;ofsBu1181ngtPlans;'(1)set of�Energy;Forins;.R=:O=W Per`rriif f6r.new construcUon,
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<br /> .^;;;:MlnimumFten;(1A)�urorfcing;dajisaafte','sutimittal'date.�:.Required onsite;:ConstiuoNon��Plans';�Stormwater•'Plans�w/SIIt�Fence installecl,
<br /> �� Sanitary`Faclllyesr&f�1;dumpstery.Site�Work�Pennit_#cr-sutidiVislonsAarge;projecfs;;.,^.n";.,:`. � ' �� ` �'-
<br /> COMMERCIAL Attach(3)'csomplete'sets"of"Bulidfng Plans'plus a�l:ife S'afety Page;�(1)set of Energy Forms.R-O-W Permit for new construcdon. - -
<br /> Minimun 4en(10)working days after submithal date. Required onsite,ConsUuction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides 81 dumpster.Site Work Permit_for all new:proj�cts:All commercial requirements,must meet compllance �
<br /> SIGN PERMIT AttaoFi"(2)sets of�Engfneered�Plans:,, --•�� �� . , � �
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<br /> '•••PROPERTY SURVEY reguired_for aII,fVEW construction.,
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<br /> �IrecNons: � .. _ . .
<br /> Fill out epplicaUon completely. �.
<br /> Owner 8 Contractor sign back of appltcaUon,notadzed � � �
<br /> If over�2500,a Notice of Commencement is requlred. (A!C upgrades over 5T500)
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<br /> qqent(for the contractor):or Powe�of Attomey"(fo�the owner)would be someone with notarized letter from owner authorizing same ,
<br /> �VER THE COUNTER{P-ERMITIING-- --� �(Front of-ApplicatlomOnly)� ,
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> Drivewaya-Not over Counter if on public roadways:.needs ROW
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