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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department � /2 �� M��
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<br /> Date Recelved , Phone�ContacYforPermlttin ' ' �
<br /> Owner's Name 1 IM� Owner Phone Number ��aZ -a a� r S�f�� �
<br /> Owner's Address � b�� �`"�� Jk Owrner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Numbe� �
<br /> Fee Simple Tltleholder Address
<br /> JOB ADDRESS ll"�� '� S � �� i'\, �1`S � 3 35�-�z LOT# � '
<br /> SUBDIVISION , . PARCEL ID# /�' � ��f������� I�O . (����
<br /> ` (OBTA11P1ED FROM.PROPERTYTAX NOTICE)
<br /> WORK PROPOSED- � NEW CONSTR ADD/ALT Q SIGN' Q - Q DEMOLISH
<br /> . INSTALL 8 ;- REPAIR �
<br /> PROPOSED�USE Q SFR. Q �COMM Q �OTHER '
<br /> TYPE OF CONSTRUCTION Q' �BLOCK " Q FRAME Q STEEC 'Q
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<br /> DE8CRIPTIaN OF WORK` '��r�� s "
<br /> BUILDINGSIZE' `SQ'FOOTAGE�� . HEIGHT�� �S !
<br /> [�BUILDING , $ ' ' I
<br /> ��Q(�.(� VALUATIONVOF TOTAL CONSTRUCTION i
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<br /> QELECTRIGAL $ � ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. , ,,
<br /> QPLUMBING - $ - I
<br /> QMECHANICAL $ ' VACUATION OF;MECHANICAL INSTALLATION �
<br /> O�S � ROOFING Q SPECIALTY Q , O7'HER� •
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> BUILDER COMPANY` SU YY���W� �J�,S C..(r� '
<br /> SIGNATURE / REGISTERED Y/ N . � FEE CURRE� ,Y'/N , i
<br /> Address ��'�O �-r �f-CaC �}A�L ��a pt, License"# CC C I�J���o��
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<br /> ELECTRICIAN. COMPANY � - � �
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� � '` � Y/N I
<br /> Address - , License:#. '
<br /> PLUMBER � COINPANY - � I
<br /> SIGNATURE` " REGI3TERED Y/-.N . ,-FEE CURRE� Y/N �� -
<br /> Address � ' , � ,
<br /> .License,# -
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<br /> MECHANICAL '� � � C.OMPANIf, • �
<br /> SIGNATURE ` REGISTERED Y,/ N , , ;; FEE,CURRE�- Y/-N � � i
<br /> � :-. ;.�. ,. _ _
<br /> Address� , .. ., ; • � '- � _License# � �
<br /> - , • . . . . _ �:. , � � ,
<br /> OTHER .:< • -� � , - ';COMPANY ` �
<br /> SIGNATURE • ._ ''�` - - � � �� `��� � " � 'REGISTEFtED�� � Y/ N.. � FEE CURRE� Y/N �
<br /> Address� . ,_ . . . � # ' • � ,.
<br /> `L'`icense
<br /> RESIDENTIAL:;�� :Attaofi`(2),;PIot-Plans;;(2)sefs`.of:Building'Plans;'(-1)sefbf'Ene"rgy�Forins;�R-O;W'Permlt:fbr new constr�ction, � ''' " � ' � "
<br /> _ :_�Minimum:te,n'(:1,0);wo,rking;days'.afte_r.;submittel'tlate:;Required onsife,:Const7uctlon-Plans;'Stortnwate�'Plans w%'Silt'Fence'iristalled,
<br /> � SanlEary FaciltUes;8�7;dumpster_Slte Work,Permitfo�_sub'dfWslons%large�projects-..��',�,:,,. ' � - - • � �
<br /> -COMMERCIAL Attach(3)complete sets'of B'uilding�Plans plus a CIfe�Safety Page;.(1)set of Energy Forms.R-O-W Permit for new.construction.> '
<br /> Minimum ten(10)woricing days after submittal date. Required onsite,ConsUucNon Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary,Facilides&:1 dumpster.Site Work Permit for all naw,proJects:.All commercfal requlrements_must meet campliance%" ` � ' � �
<br /> SIGN PERMIT AttacFi'(2)sets of�Enginee.r,ed•Plans.,,•:�.::��;;.'- �". �" _ � - - � , . .. .
<br /> - ""PROFERTY SURVEY,required,for_all NEW,constructlon. _ ... _._ _ "t�.._.
<br /> _�:__... .._..__.....,.�._�. , _ . ;.
<br /> - _ -•:� : :,� .,
<br /> DIfAC�IOflS: �-'',_;..�r.,,•,. ;_" ��.�.-_ _-' ... .
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<br /> Ffll out applicatlon completely. �
<br /> Owner&Contractor sign back of applfcatlon,notarized
<br /> If over�2500,a Notice of`Commencement is required. (A!C upgrades over�T500) , ,
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<br /> .�:: �:>�.. '-• ....�.. - - - - -
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<br /> " Agenf(for tFie contractor)or"Power of Attomey�(for the'owner)would be someone witFi notarized letter from owner authorizing same
<br /> .. - � . . :..:=,�_r..,':`
<br /> 'OVER THE COUNTER PERMITTING------:-(Front'of-AppAcatlomOnly) - • •-" ' ' ' ' • - - � � � '
<br /> eroofs if shingl,es Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) �
<br /> _ .'-.._ ,.........._ ...._ ..... ..,-.:_ -.:-:.-•���,. ,..v_.v-:.*..� '- . �e_ .. ,<-..-�. . - ,�-, .
<br /> vewaya-Not over Counter if on pub8c roadways.,need's ROW",- - • , . - -'-'�_`..°"""''"-�•'-` ='_'-•''" ``� � -
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