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s�aa8aoozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> - Buiiding Depar6nent
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<br /> Date Recelved - _ Phone-Contabt�for Permlttln —
<br /> Owner'a Name '�'� ' �' 6� �(��� �M �'1 Owner Phone Number �����7�(C � �
<br /> Owner's Address �2�y �./�P '4/ l=� Owner Phone Number
<br /> Fee Simple Titleholder Name ' Owner Phone Number ' —�
<br /> Fee Simple Titleholder Addres� .
<br /> JOB ADDRESS ��� t v M'� '� LOT# �
<br /> SUBDIVISION � �1 Q. U 1'� � � PARCEL ID# �ZS --Z� ��� —v�����D 7��
<br /> . ,,, (OBTAINED F.ROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED •,NEW.'CONS7R ' ADD/ALT Q SIGN` �Q Q DEMOLISH
<br /> . B: INSTALL e ;. REPAIR �• -
<br /> PROPOSED�USE � Q SFR, Q COMM - ' Q �OTHER ' ' � �
<br /> TYPE OF CONSTRUCTION � Q • 'BLOCK " Q . FRAME � � STEEC 'Q
<br /> . - � � v� t�► c� . .
<br /> DESCRIPTION OF WORK' � �
<br /> BUILDING SIZE ` "SQ`FOOTAGE '! � . , HEIGHT , (�
<br /> QBUILDING , $ �•'OO VALUATION�OF�TOl'AL CONSI'RUCTION '
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<br /> QELECTRIGAL $ ' ' AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. ,
<br /> QPLUMBING $ � �
<br /> ` �f/� ���
<br /> QMECHANICAL $ VALGATION OF�MECHANICAL INSTALLATION V
<br /> Q�►S Q ROOFING .Q SPECIALTY Q OTHER ,
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER COMPANY - �� ���
<br /> SIGNATURE � ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address � .�G �'1 .f f�r � � L:icense#
<br /> ELECTRICIAN; ,,, COMPANY `
<br /> SIGNATURE � �' REGISTERED Y/ N FEE CURRE��' `Y/N
<br /> Addre�s � • -Ucense# � � —�
<br /> PLUMBER � COMPANY � �
<br /> SIGNATURE' " , REGI3TERED X_/�-N.. EEE CURREP Y/N
<br /> Address _ License.# . �
<br /> MECHANICAL �� C.OMPANY �
<br /> SIGNATURE� "' ` ' r�GisTEiieD . Y.,/ N FeE Cu�n Y/�N . , �
<br /> Addre�s� � ' . : „c � : � ' ' License# „
<br /> :. , . , � `- :>�-'. ., �. , . -
<br /> , ,. k: ..
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<br /> OTHER ;= . _ , .�COMPANY, . . . .. , ., .,. .. .. _
<br /> SIGNATURE �- - ` " �� • ' � ' ° "REGISTERED` Y/ N..-� FEE CURRE� Y/N
<br /> Address ' y_ 5:�� � J v UCBI�SB R
<br /> RESIDENTIAL;;,� AttacH;'(2�)„P-.Iot-P,lans;;(2)sets�:of�Bulldingf Plans;'(1)sef of-Energy Fortns;`-R=O=W Perrrilt for new oonstrucUon, � -
<br /> ; ,�::Minlmum:ten,(�1.0):working°days after,>submlffal date:°°,Requlr"eil onslte,:Constiucdon'Plans;Stormwater�Plan�s w/Sllt Fence tnstalled,
<br /> � "SanlfaryFacllldes�&;,1�;dumpste,r,-Site';.W.ork�Permlt�forsubdiylslons/lerge;projects•__ `: ' '*
<br /> COMMERCIAL Attach(3)�comple4e'sets`of Building Plans plus a Llfe`Safeiy Page;(1)set of Energy Fortns.R-O-W Permit for new constructton: �
<br /> � Mintmum ten(10)working days after submlttal date. Required onsite,Constructlon Plans,Stormwater Plans w/Sflt Fence Instelled,
<br /> Sanitary Facltides 8 1 dumpster.Slte Work Pertnit for all naw.projects..All commerclal requlrements.must meet compllance' •
<br /> SIGN PERMIT AttacF�"(2)"sets"of�Engineer.ed�Plans.; .:-:��=�s . - ,. ' � -
<br /> "'•PROPERTY SURVEY required for all,NEW.construction.
<br /> Dlrectlons: � -....,.� � � �
<br /> FIII out epplicaUon completely. ,
<br /> Owner&Contractor slgn back of applfcaUon,notarized
<br /> If over�2500,a Notice of Commencement Is requlred. (AIC upgrades over 57500) ,
<br /> Y, :-��;,.,.:,;;•
<br /> " Agent(for the contractor)or`Power of Attorrmey�(fo�tFie`owner)would be someone with�notarized letter from owner authorizing same •
<br /> DVER THE COUNTER.PERMITLING-- ---(Front of ApplicaUon•Only)- '
<br /> Reroots if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
<br /> Drlvewaya-Not over Caunter If on publ(c roadways:.needs ROW
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