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813-780-0020 City of Zephyrhills Permit Appiication Fax-813-780-0021
<br /> �• ; Building'Department
<br /> pate Receiv,eth,� r � I� �`~I p►ya�e Contact far Permitting —
<br /> Owner's Name �a��� ��►r"1� ��/Y1'te-+r.s �C11C'')l.�.r�� .� Owner Phone Number � �� � ��� �
<br /> Owner's Address ���2"2 ��1 YI �i"" �1r'� Ov�rner Phane Number � �
<br /> Fee Simple Titleholder Name �— � Owner Phane Number �� �
<br /> Fee Simple 7itleholder Address
<br /> y ��f�^ �"t �I 6��,.il�,��(} �{,f"1� (nt.�Y�9�t�7 �J�� t 2 LOT# �
<br /> SUBDIVtStON �I t���S � PA�RCEL![3# %�Y a� ��l��6��f"'k��'� l!
<br /> (OBTAINED FROM PROPHR7Y TAX P70TICE)
<br /> WORK PROPOSED e . NEW CONSTR 8 ApD1AtT [� SIGN Q Q DEM4i.ISH
<br /> INSTALI. REPAIR
<br /> PROPOSED USE � SFR Q COIVlfitl C� OTNER
<br /> TYPE"OF CONSTRUCTION Q BLOCK • Q FRAME � 5TEEL Q
<br /> DESCRIPTION OF WORK ��� � ��� `����� � �� �mP -� '��a�
<br /> BUtCC11NG S1ZE �� � SQ FOOTA6E C��� HEiGHT ���
<br /> Q8UILDENG �6 � VALUATIOtV�t)F TOTAL CON5TRUCTION
<br /> ��LECTF2lCAL $ �, ���.VO AMP SERVIGE 0 PRC}GRESS ENERGY Q W.R.E.C.
<br /> �PL.UMBING ��� pv�<e .
<br /> �r�,�����.Q .
<br /> �MEGHANICAL �� VALUATtQN OF MECHANICA�INSTALLATtON �
<br /> QGA5 Q CtOQFING Q SPECIALTY � OTtfER .
<br /> FINISHED.FLOOR ELEVATIONS ��� FLOOD ZONE Af2EA QYEB NO
<br /> - - B►JILDER - -- GOR9PANY .. . ` _
<br /> SIGNATURE _ REGISTERED Y/ IV FEE CURRE� Y/N
<br /> Address Lioense# �� �
<br /> ELEC.TRiClAN fl �� COMPAt+tY �CAU} G� �� GJ�."'�'t7� `�#tS'�" ��G�S ��p�
<br /> SIGIdATURE � REGISTEREp / N FEE CURRE� Y/N
<br /> Address ���� d.�/ 1�D�l License# ��- ��� �� I-� I
<br /> PLUMBER COtUlPANY
<br /> SIGNATURE 'REGISTERED Y/ N FEE CURREt� Y/N
<br /> Address � , License# � �
<br /> MECH%i[�i1CAt. CGIMPANY �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 6 N
<br /> Address License# �— �
<br /> ,. �
<br /> OTHER'' - COMPANY -
<br /> SIGNA7'URE..,- REGIs'rettE� Y/ N FEE CURREK Y/N
<br /> Adciress License# �— �
<br /> RESiDENTiAL�= Attach,(2j:Ptaf P1ans;{2)sets df�Bui[ding�Plans;{1)set af Ettergy Forms;R-Q-W PermiE far new constrvctian,
<br /> , � Minimum;.ten;(;10)working�days after subrriittal date. Required onsite,ConstrucUon Plans,Stormuvater Plans w/Silt Fence installed,
<br /> ' t Sanita.ry:F,acilities.&�1<dumpster;Site Wark Permit far sutidivisionsllarge projects '
<br /> COMMERCIAL Aftach(2)cottiptete sets af Suitding Ptans plus a Li€e Safety Page;(1}set of Energy Forms.R-O-Vtt Permit for new consfruction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucBon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&9.dumpster.Site Woric Permit fo�ai!new projects.AI!commercfat reguirements must meet compliance
<br /> 'StGN PERMIT Aftach(2j sets of.Engineered Ptans."' - "
<br /> ***"PROPERTY$URVEY cequired for all NEW canstruction. '
<br /> �Direc'tions:
<br /> Fill out application completely.
<br /> Owner&Contractar sign back of appticatian,natarizad .
<br /> if over$2500,a Notice of Commencement is required. {AIC upgrades over$7600)
<br /> *' Agent{forEh'e conti�actor)`or Power ofAttomey(for ttie owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (copy of contract required} �
<br /> Reroofs if shingles Sewers Servlce Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Drlveways-Not aver Gounter.if..c��publi¢�roadwaysyneeds�ROW""'� ���� �" ""`'.._ '�3��'{"�,r��.*,.��;������, '",�"� '
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