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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 "
<br /> � , � Building Department =�
<br /> Date Received ` �� � d� Phone Contact for Permitting � O l l - �1
<br /> Owner's Name rn ��� Owner Phone Number (��� � �C (F.� �
<br /> Owner's Address 1 �1(�L`1 � Owner Phone Number
<br /> Fee Simple Titleholder IVame Owner Phone Number
<br /> Fee Simple Titleholder l4ddress
<br /> JOB ADDRESS � I Cl.�l� � ' LOT# �
<br /> �,i SUBDIVISION - PARCEL ID#
<br /> y � (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> �.� ;
<br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q Q DEMOLISH
<br /> �� � INSTALL REPAIR "
<br /> Ij PROPOSED USE Q SFR ,_ Q COMM Q OTHER
<br /> t� :
<br /> �f TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
<br /> f�1 DESCRIPTION OF WORK 1 \ t�ie, 3� rn�`(J� U�-�pm� .Q �-Y1,1 I
<br /> �f `�
<br /> � BUILDING SIZE SQ FOOTAGE� HEIGHT
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<br /> j; QBUILDING $ VALUATION OF TOTAL CONSTRUCTION
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<br /> � QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C:
<br /> � ! .
<br /> � QPLUMBING $ , �/ ��Q�
<br /> � t j � C�
<br /> ' � �
<br /> :? �MECHANICAL $� (� �'� VALUATION OF MECHANICAL INSTALLATION
<br /> � , � �
<br /> � QGAS Q ROOFING Q SPECIALTY � OTHER � ^ (�` � .
<br /> ' , � �OW
<br /> � FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> z BUILDER COMPANY -
<br /> � SIGIVATURE REGISTERED Y/ N FEE CURRE� Y./N
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<br /> � Address License#
<br /> I ,
<br /> � ELECTRICIAN COMPANY
<br /> � SIGNA'PURE REGISTERED Y/ N FEE CURRE� ' Y/N`
<br /> a -
<br /> Address � � License# ' ' '
<br /> ` PLUMBER � COMPANY � -
<br /> � SIGNATURE REGISTERED • � 'Y'/ N FEE CURRE� ' Y`/•N �
<br /> � Address - �
<br /> License# .
<br /> �
<br /> , f l,��' /� �� �_
<br /> ' MECHANICAL' �� �,[� � COMPANY� ���r`� l.l��'��SoG��
<br /> ; SIGNATURE �!^�-—`". . REGISTERED� Y/�N.�• ,= FEE CURRE� - �;.Y./N �-
<br /> �, � /�/s y�
<br /> , Address o� " ^ ��� � 4.� 1 � . , C��l����a-/�
<br /> License#
<br /> OTHER , COMPANY
<br /> i. SIGNATURE REGISTERED Y/ N FEE CURRE� Y.../N,
<br /> �_
<br /> � Address License#
<br /> �E�. -
<br /> �; RESIDENTIAL= � =Attach�.(2)Plot Plans;'(2)'sets of Building'Plans;(1).set of Energy Form's;:R;0-1N:.Permit'foc new construcGon,. .
<br /> �'�`- Minimum-�ten:.(>1:U)'.working cJaysafter_su6mittal date. Required onsite;�Construction�Plans;Stormwater Plans wl Silt Fence installed, _
<br /> -�� -•-- - - - -
<br /> s" Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> CORIIMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Fage;(1)set of Energy Forms.R-O-W Permit for new:construction.
<br /> - Minimum ten,.(10)working;days after submittal date. Requi�ed onsite,Construction,Plans,Stormwater Plans w/Silt.Fence installed,
<br /> Sanitary Facilities&'1'�dumpsfer.Site Work Permit for allTrieuv p�ojects.All commeroial requirements must meet compliance �
<br /> '•` - SIGN PERMIT Attach(2),sets of Engineered Flans. , �;
<br /> ***"PROP,ERIY.SURVEY required for all NEVV construction. .
<br /> Directions:
<br /> Fill out application completely.
<br /> Owner.8�Contractor sign back of application,notarized
<br /> If over$2900,a Notice'of Commencement is required. (A/C upgrades over$7500)
<br /> ** Agent(for the contractor)or-Power�of Attomey(for the owner)�wotild be someone with notarized letter from owner authorizing same
<br /> -OVER:THE COUNTER PERMI'1'TING (copy of contract required)
<br /> Recoofs if shingles Sewers�=-• ��-.Service,..Upg[ades NC - Fences(Plot/Survey/Footage) � -
<br /> � j;C:�:t('S.':4' '.7 : ,�ii"i" • O�fl�. '• , `i,.•'J,� roa,..._ j.. _ ' '. .�: __-, r
<br /> Driveways-Not over Counter if on�public road�iays..'needs;R. �� ;, •�- �� - : � � ,_ .
<br /> `. ,�.. " ` ' `., . :r;l:_ •'.i. , `G.":FC1ii c.c . ,.,,.�. ,,._
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