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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Departrnent .
<br /> Date Receiv�d •
<br /> � � - � °�.Phone�Contact'for-Permittln - �-
<br /> Owrner's Name � /0 Owner Phone Number �����a-'`C� ! � �-
<br /> Owner's Address ��f� � • Owner Phone Number •
<br /> Fee Simple Titleholdee Name ' . • r
<br /> Own�r Phone Number �
<br /> Fee Simple Tideholder Addresa � � ,
<br /> JOB�1DDRESS 6 � LOT# �
<br /> SUBDIVI310P1 I�� . . ° P.ARCEL ID# n � , -
<br /> ' � • �� (OBTAINED FROM PROPERTY,TIUE WOTICE) • I
<br /> WORK PROPOSED •.z,NEW�CONS7R� ADD/ALT � � SIGN'� `Q, • Q DEMOLISH
<br /> , �.,e. INSTIJ:L.. � :,.REPAIR ..- , , �
<br /> PROPOSED2USE .. ::[�� SFR. � ��COMM `�[� �OTHER'�'� � � °
<br /> TYPE OF CONSTRUCTION <• Q` '•BLOCK " Q FRAME � '� 'STEEC Q �
<br /> t,�` // � � t 4
<br /> DE3CRIPTION.OF WORK T/��-(_. ,e/`�(A � C'�, 1 f�,�t'�, '� • ,
<br /> BIJILDING'SIZE ' '� - �`"SQ''FOOTAGE ' � ,HEIGHT��. � .. li
<br /> ,,��:. ,;
<br />' QBUILDING $ " �5CJ ' �,.. ' '` � • -
<br /> - ��(,�y �" VALUATION�OF TOTAL CONSTRUCTIaN � '
<br /> Q�LECTRIGAL. - $ - AMP SERVICE ' Q =PROGRESS ENERGY Q W.R:E.C.
<br /> OPLUMBING• ;$ - '- -
<br /> , • � �G ��W/
<br /> QMECHANI6AL " $ ' VALUATION O.F MECHANICAL.INSl'ALLATION.
<br /> :.. . - ����7
<br /> Q�S, „ , Q ROOFIf�[G Q SPECIAITY;� OTHER� , � ,
<br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO �
<br /> BUILDER COMPI�NNYr- � �` •,� � /` �
<br /> SIGtdATURE REGISTERED / fV �FEE CURRE � Y/'N
<br /> /iddress � L;icense# ' '
<br /> ELECTRICIAN�;,.4. ;, . - �= r:;COMP�4NY, :. - � . ' . � .
<br /> SIGNATURE � REGISTERED Y I N FEE CURRE��' �� rY/N' '
<br /> Ad�resa's' , . . �,. � , , Y; . , - F , , t , . Ucense:#, �- - '
<br /> PLUMBER'': , ' . � - ' ,COMPAtdY . . � ,
<br /> SIGNATURE''"`�`' " � • �� '.REGISTERED - .Y L,.N•- eFEE Cl1RREA� X./N: •
<br /> , , �p. .. --- - - � -
<br /> Address � x. , . ` ,:Licerise,#; . -` _�
<br /> , " " '- _ .. . , �c�}_.�
<br /> . ��'.. ... . - . _ , Li.. r "_ '
<br /> AAECHAPIICAL`` : '' _ COMP�INY , .. '
<br /> 51GNATURE. ,Y •�� ,, . �- - . - � ; - , ,_, � � r:=,:> . . ;. _.., ,....�..
<br /> REGISTERED�,, Y,/.N. ; � FEECURRE� Y,6N. . -
<br /> � - - �,�j: � ,. �_-. , -
<br />' Address='`�...- - �" .. . _ �x..-_.., , .. >• . .... � � ' Licen$e#, , —.. ., � , �
<br /> •<.�i.. -l- ., - , . ..-._ .. _.. _ ...... , < ... ,� ,
<br /> OTHER , ,.,-_ . . ... .- .. _ . ,- . .��:;. _.. ..-,P - ��, �, , �• . , . - � -
<br /> SIGNATURE" . . �_ , .. , .. .. COMP%�Nlf �� : � " '
<br /> rG r�: ,yv��;� `�� ;=.F:i3 1'�.y�,;,.�., . . ., ,._._ . ..
<br /> �REGISTERED Y/ N... FEE CURRE� Y7 N: __^_
<br /> - y _- — ;,„ m -;�-_- -- . .� ...:: . ,. ". — _� , '_ ..--< _ -_ ---
<br /> Addr�ss' �,.;_ ���:,:��:�; - z-��-: - ,. `' " ` -License#'' � ; ` . . , �
<br /> �RESIDEN 'q(t�i . �.::�:,.,... ., �. ,.,,:��-��. �.-.,.;. .�.;: • .,,:,;, _ : .. , ,.,,.,� : �. �
<br /> TIAI�k:';r", icFi'"(2)�PIot;Plans;,(2)sefs_:of�Bullding}Plan's;(.7)seto�En'ergy}Fortns;R�O=W-Perit%lf fornew constructlon, "
<br /> ,,:;.�hsw Mlnlmum}ten�(o1,0);,virorking�dajis;�_afterxsubmlftal'dafe.�Requlred orislfe;�:Consfni�'�don"Flans;Stortnwater Plans�w%SI(t Fencs In�talleii, -
<br /> • 'Sanitary'FaajltUes�&F,lsdumpster;•�Slta��Morlc;Pertnit�.tor�.subdivisloits/lerge':prriJect"s`;'s:,�;�* ' • - . � .. .,_ . ". `J- .
<br /> COMMERCU�L Attech(3)�cainplete`sets`of'Bu`ilding Plans plus a'`Ufe Sefely Page;(i)set of�Eiiergy Forms.R-O W Permitfor new construcUon. �
<br /> . Minfmum ten(10)working days'after submltfal date. Requfred onslte,ConsUuctlon Plans,Stormwater Plans w/Sflt Fence Installed,
<br /> � Sanitary FaclliUes 8�1 dumpster.Slte Work Permlt for all newtprojects::i411 commerGal�es�ulrements_must meet compllance "' � •
<br /> �;SIGN�PERMIY Attacfi°(2j;sets of"Engln�eered,;P,lans:i=:s::.:,�,�^�:-"h:i•;�:`r �y>;:=�� � .-. . . � r. - '
<br /> ""PROPERTY SUR1/EY reyulred,fQr all IdEW constcuctlon.,__. _.�.._. _._
<br /> �Dlrectlons: , �,.�.:,�- r,: .,_ . - � ` -
<br /> FIII out applicadon completely.
<br /> Owner 8 Contractor slgn back of applfca8on,notarized �
<br /> If over 5�500,a.Notice.of.Commencement Is requlred. (AIC upgrades over 57500) _
<br /> :54.�i.'��i'_�1's:�i.�:.L
<br /> " ent for the 6ontractoc�or Po6iie�'of Attome for the owner would be'someone wlth notarized letter from owner authorizin same
<br /> �l9 � ) Y�� .� _�._...- �u-- 9
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<br /> °DVERTHECOUN.T;E�t.PERMITI7NG-----:>�(Front<ofAppllcaUon•Only)�-��•- ��
<br /> Reraofs lf shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footaga)
<br /> ...�`i-«�.,.�ai,- � -. � . - . ; . _ • ,_,
<br /> Drlveways-Not over Counter(f on publlc roadways:.need`s ROW`
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