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$�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> " Building Department
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<br /> Date Received , Phone Contact for Permitting � —
<br /> Owner's fdame �� 1 (n�I G4 r� Owner Phone Number
<br /> Owner's Address ���� �, Iln E'. Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS �p �� � �j �I'�'�'.� `�� LOT# �
<br /> SUBDIVI$ION PARCEL ID#
<br /> (08TAINED FROM PROPERTY TAX NOTICE) �
<br /> WORK PROPOSED B _. NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH
<br /> IiVSTALL REPAIR
<br /> � PROPO,SED USE Q SFR Q COMM 0 OTHER
<br /> TYPE:OF CONSTRUCTION Q BLOCK •- Q FRAME. 0 STEEL Q
<br /> I DESCRIPTION OF WORK C���LI �C' (� V�I � ���
<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ VALUATION"OF TOTAL COIVSTRUCTION
<br /> �ELECTRICAL $ �O��� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ I
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> Q,GAS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES ,NO I�
<br /> �.BUILDER _ COIlAP9�IdY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 7 N. .
<br /> Address �� License#
<br /> -'ELECTRICIAN //��,r(�( COMPANY - � S� l.(C(SS � C'�"�(
<br /> SIGNATURE v° �� � I�� REGISTERED Y/ N �FEE CURRE� Y/N
<br /> ada�ess �`1! ` � ad )�J . 3��� License# �C d C D ZS'�(�, �'
<br /> x�::• - .
<br /> PCUiNBER.,. _COMPANY= ; ` � "
<br /> SIGNATURE � REGISTERED Y.•/�N. _ .FEE CURRE� Y/N
<br /> Address License#`
<br /> MECHANICAL � � COMPANY
<br /> ` SIGNATURE'" �� REGISTERED , Y,/ N - " FEE CURRE� , . Y_/N
<br /> I Y t ~ .
<br /> AdB�ess'�` � License# _
<br /> ,�;t�. s- ... ,
<br /> �OTHER�. .:." _�� ' COMPANI( - �
<br /> ''SIGNATURE��=,:=, .� - - � � • REGISTERED Y/ N_ FEE CURREK Y/N
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<br /> Addressr; '�°�� License#
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<br /> �`�RESIDENTIAL^,:,"AtCac6;(2);PlokPlans;`,(2):sefs�of�Buildirig�Plans;(1�)°setof�Ene�gy:Forins;R;O;W,Permit-,fornew.constiuction, -
<br /> - _-••-•;Minimum,ten.(10)�workingeday`s'aftersubinitfal:dafe. Required'onsite;Constr`uctionPlans;Sto[mwater�Plans w/Silt Fence installed,
<br /> - . -�;`;'�:;3�t{� .
<br /> � . �� �� " Sanitary�Facilities:&r1�;dumpster;�Sife;Wor,icPermitfor•.sutidivisions/large;projects ' ' ��+ � �
<br /> `�:C.OMMERCIAL Attach'�2 com lete�'seGs`of'Buildiri-Plans� lus a Life Safe Pa e; 1 set of Ener Forms.R-O-W Permit for new construcUon.
<br /> � ) P 9 P tY 9 � ) 9Y
<br /> " - Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Pians w/Silt Fence installed,
<br /> ;;�:; Sanftary Facilitfes&1 dumpster..Site Work Permit"fo�°all-neuv piojects.All commercial requirements must meet compliance
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<br /> L:�;.SIGN�PERMIT '�Attacli(2)`se4s,of;Engineered;Flans.�� . -
<br /> :,.,�.
<br /> �=��- ""'PROPERTY SURVEY required for.all.NEW.construcUon.
<br /> - �. . _ .._.,,. � .
<br /> ;Directions: ��= , .. .:t . �
<br /> `= � Fill,.out�application completely. ,
<br /> �Owne[&Contractor sign.baok of application,notarized �
<br /> ,If bver$2500,a Notice of Commencement is required. (A/C upgrades over$7500)
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<br /> '°" Agent(foi'tti'e'dontracto�)ror Power'of'Attomey(for`tFie owner)would tie someone with notarized letter from owner authorizing same
<br /> '"'OVER�:THE COUNTER PERMITTING, .__. (oopy.of contract-required) ' � �
<br /> ,:;Reroofs ifsfi(ngles Sewers Service Upgrades A/C Fences(PIoUSuroey/Footage)
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