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813-780-0020 ; Ci4y of Zephyrhills Perrr�it Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Received � a� J� Phone Congac4 for Permi4ting ��� � ga -- (�c��
<br /> Owner's P�aene � Y"' 'I� (^ S Owner Phone fVumber l]r�' ��'`�'��
<br /> Owner's Address �a r a L�.�d ov�� � Z � � Y 11�� Owner Phone Rluenber
<br /> Fee Simple Titleholder PJame Owner Phone R�umbeP
<br /> Fee Simpie Titleholder�4c9tlress
<br /> JOB ADDFZESS �I � n OVQ( r� � ��' 1( I`S � � ��5 l O LOT# S�
<br /> susoivisio� � j�C�. U�' ���k �S -� PARCEL ID# �5-as-a i -ao50-�- p5�o
<br /> (OBTAIPIED FROM PROPERTYTAX PlOTICE)
<br /> WORK PFiOi'OSED B NEW CONSTR e ADD/ALT � SIGN 0 0 DEMOLISH
<br /> INSTALL REPAIR
<br /> PROFOSED USE 0 SFR Q COMM 0 OTHER
<br /> TYPE'OF COIdSTRUCTIORI 0 BLOCK • Q FRAME 0 STEEL Q
<br /> DESCOdiPTlO�OF WORK �CC� C�t't' �L��I C'O �I S �` I�p cS lDl� ��l � c�5 (.,Y�l. I �I !
<br /> �UIL'DIR�G SIZE SQ FOOTAGE� FIEIGHY
<br /> �BUILDIiVG $ / Q a� 60 VALUATION'OF TOTAL CONSTRUCTIOfV
<br /> UU
<br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS EIVERGY Q W.R.E.C.
<br /> OPLUMBING $
<br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION :,� �����
<br /> OGQS Q ROOFING Q SPECIALTY 0 OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZOIVE AREA �YES iV0
<br /> BUILDEid COMPMR�Y
<br /> SIG�VA�PURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> R+ddress License#
<br /> ELECTRICIAPI COMP�RRIY
<br /> SIGf�P�TU1dE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# y
<br /> PLUijfIl B ER. COiUV PAP1Y
<br /> SIGRIATUPaE -REGISTERED Y�/ N- FEE CURRE� Y/N
<br /> Address License#
<br /> MECHANICAL � CONiP,�PlY
<br /> SIGf�ATUf3E REGISTERED Y/ N FEE CURRE� Y/N
<br /> Adilre"ss- � License#
<br /> OTHER' � �� ( O �(�-� �C-
<br /> SIGRIATURE.� RE ISTERED / N FEE CU E� /N
<br /> ,4ddress �p� S� .5 l � ( �'I� ��S �� License# cc [�a s 5r��
<br /> RESIDEPfT1,4L �, Attach-(2):plot Flans:`(2)-sets•of'Building Plans;�(1)set of�Energy Forms;R-0-W Permit,for new.construction,
<br /> ,_ Minimum.;ten,(;10)working days aftersubmittal�iiate. 'Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary;F.acilities.&�.-1,�dumpste,r,Site�W.or;k�Rermit for.sulidi"visions/large projects.
<br /> COflflflflERC1,4L Attach'(2)=complete"sets of Building"Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster.Site Work Permit foF all new projects.All commercial requirements must meet compliance
<br /> SIG�PERiVIIT Atta6li(2)sets of�Engineered Flans.�
<br /> *"**PROPERTY SURVEY required for.all.NEW construction.
<br /> Directions: - -
<br /> Fill out application completely.
<br /> Owner&Contractor sign.back of application,notarized .
<br /> If over$2500,a Rlotice of Commencement is required. (A!C'upgrades ov�r$7500)
<br /> ," Agent(for 4h�e cont�actor)�or Power of Attorney(for'the owner)would 6e someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTEI2,PERfVii;P.T,I�IG.: ...__,.,(copy,of contract required) :°, ••"��- --•� �-•--•�=
<br /> . ... _-_..,:. . ..
<br /> Reroofs�if shingles,� "-Sewers , Service Upgrades A/C Fences(Plot/Survey/Footage) ` :�•i i', •: . ., � � � � �
<br /> ,� ` `•, '' ,i ;F , � - i
<br /> Drivevuays-Not over Counter�if on',public roadways..needs ROW ; � � • _
<br /> •'�' . .,.. . . .�., .. 5.,..s-.- �. :Sr,.�., - .' ' . '!i
<br /> _....:. .. ....:.._. , _ .. . „ti..: 1-� � ,,. .. , �S�
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