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813-780-0020 ; Ci4y of Zephyrhills Permit�4pplication Fax 813-780-0021
<br /> • , Building Department
<br /> � - ,
<br /> n�qe Reaeived _ /' a �''] /�Q
<br /> 1 v � I� Phon�`Conqac�for Permi44ing � ��.J l ��� ��LJ l
<br /> Owner's Rlaene '��'t1 �(�U � Owner G�hon�h�umber �I� �� ( `p -T�I
<br /> OwneP's�,ddress. •J �� an C r hl��I s I Own@r Phone F9umb�r �
<br /> Fee Simpl�TiQleholder'Nam� �WP1�P I9GlOP10 R�4lP17��P
<br /> Fee Simple'PBtleholde��4�dPess '
<br /> JOB�ADDI3ESS I 4� Cl.n On C-J ( �1 I�� �I ����{ L07� �
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<br /> su�Divo�io� �,a�c��.i�� a�a�-a I � Ua l U - C�(X�l� — ` �
<br /> i (OBTAINED FROM PROPERN TN(PdOTICE)
<br /> WOfi�C PROPOSED I NEW CONSTR ADDIALT � SIGN Q � Q DEMOLISH
<br /> i B INSTALL e •REP/AIR
<br /> �ROP,,OSIED USE I Q SFR Q COMM 0 OTHER
<br /> 7VPE'OF CORlSTiiUCTIOPI i Q BLOCK • Q FRAME � STEEL Q �
<br /> DESC921PT10�OF.WOEtFC ; ��-�1 � ����(.Vt` Se �� ����� r ti
<br /> � �j fi C
<br /> �ui�Di��siz� � sQ Foo����� o-aei��a� � el�i�((�n�
<br /> �BUILDING ' $ VALUATION'OF TOTAL CONSTRUCTION
<br /> , cG'�
<br /> �
<br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS EfVE Y � W. . .
<br /> I QPLUMBING � $
<br /> , �
<br /> � ��153
<br /> OMECHANICAL ' $ VALUATION OF MECHAIVICAL INSTALLATION
<br /> �GQS � Q ROOFING Q SPECIALTY � OTHER
<br /> FIIVISHED FLOOR ELEVATIOfVS FLOOD ZOfVE AREA DYES fV0
<br /> �UIL�ER COMPP,V�Y
<br /> 5�������� REGISTERED Y/ N FEE CURREA Y/N �
<br /> ���P�s� License#
<br /> ELECYI3I.CI� COf�iPAf�Y
<br /> SIGi1�iQ�PUI�E REGISTERED Y/ N FEE CURRE� Y/N
<br /> ,�c➢dress Cicense# U
<br /> �LU�II��pZ. , COiiIYP4�,PBY�
<br /> 51G�111�'B'U92E REGISTERED Y•/ fV- FEE CURRE� Y/N ,
<br /> P�ddress � License#
<br /> NiECOii�ICi4L � COPdJ�R�fdY
<br /> S9GR9�iTURE' � REGISTERED Y/ IV FEE CURRE� Y/IV'
<br /> Ad�7re'ss � License.#
<br /> ,�,. .
<br /> OTIiER- ; � COMFR,IVV �' ^�( � � ��C
<br /> SIGP�AYUFZE:� :i REGISTERED Y/ N FEE CU E� /RI
<br /> ��dP�ss y 13 (hl I�� �� � License# l�C��10�S S d S
<br /> RE�IDEPlTIAL�.r; Attacli�'(2)sPlot<Blans;�`(2)ssets�of�Building�Plans;�(1j`set'of'Energy':Forms;",R-.Q,V11:Permit.fornew.construction,.
<br /> • - _, �.Minirnum::ten;(1'Q.)_w,otking?days�after,-sutimittal�date. Required�onsite;'Con`struction Plans,S'tor.mwater Plans w/Silt Fence installed,
<br /> � Sanita,,ry:.;Facilities�;&�1�,.dumpste.r•;S;,,ite+ ,W.ork Rerm'it for•,subdi'visions/large projects�
<br /> COMME6tClAL Attach�'(2)�complefe"sets of Builcling"Plans plus�a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Minimum ten(10)woricfng days after submittal date. Required'onsite,Construction Plans,Stormwater Plans w/Silt Fence•installed,
<br /> Sanitary Facilities&'1 dumpster.Site Work Permit fo�all•new projects.All commercial requirements must meet compliance
<br /> •SIGN PERNi17' Fittaali'(2f�sets of�;Engineered Flans.�
<br /> *""*PROPERTY SURUEY required for..all.iVE.W..constcuction.
<br />� Direcgions: � . . � �
<br />� Fill out application completely. ���
<br /> Owner�Contractor si b`
<br /> n acic of.
<br /> a licati ,
<br /> 9
<br /> PP
<br /> on notarized
<br /> if.oveP$2500,��O$IC@ Of�COR7P17�PIC0M@Plg YS P�Of6d�P��. (�JC u�grades ov�r�7500)
<br /> ** Agent(for�the'cont�actor)•or`Power of'Attotney(fbr'the ovuner)would 6e someone with notarized lettenfrom owner authorizing same
<br /> OVE13 7F4E'COUN7ER-pERiVi1�'I iR9G. (copy.of-contraet�required) -
<br /> I Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> , �. ..,`.�. ._ - _ -�
<br /> Driveways=NotoVer Couriter ifon public roadways..needs ROW , ;.. (•.,-�:� , -. - - - � � ;;�
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