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e�saeo-oozo City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department - `
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<br /> Date Recelved � d�7 l' 7 phone=Contact for Permittln ' �� ' �
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<br /> Owner's Name �W Owner Phone Number
<br /> Owner's Address �� /v• ' �Tle � Owner Phone Number �
<br /> � �Fee Simple;Tltleholder Name % � Owrner Phone Number
<br /> Fee Simple�Titleholder Address
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<br /> JOB ADDRESS ` '�z . � � LOT# �
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<br /> SUBDIVISION PARCEL ID# °
<br /> i - , , , (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN� Q Q DEMOLISH
<br /> ; INSTALL � REPAIR •
<br /> PROPOSED+USE SFR. Q 'COMM Q �OTHER " - �
<br /> TYPE OF CONSTRUCTION �� BLOCK " FRAME [�� STEEL
<br /> DESCRIPTI,ON OF WORK , �d-� � � Do � J� �3 �(S�, � C�, C j a-d
<br /> �UILDING$IZE � � SQ FOOTAGE� . . .,,HEI,GHT�� . �� � �
<br /> QB,UILDING $ � VALUATION;"OF�TOTAL CONSTRUCTION ^ '
<br /> QELECTRICAL $ ' AMP SERVICE [� PROGRESS ENERGY Q W.R.E:C.
<br /> QPLUMBING �$ '
<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '� �� �q�
<br /> QGAS Q ROOFING .Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. NO
<br /> SIGNATURE COMPi4NY� "�-� LZ%� � �` �,�
<br /> REGISTERED Y/ N fEE CU A Y'/N
<br /> Addres� Q v�(� �t r Cicense# � y���y
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<br /> ELECTRICIi4N:. � � :`COMPANY ' -
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE�" `Y/M
<br /> Addre�s " ' , - Ucense# .
<br /> PLUMBER=� , , �. COMPANY . . ��
<br /> SIGNATURE' _ t , REGIST.ERED Y/,,•N; ;•.'�;FEE CURREA Y/N ,�
<br /> Addre$s . , `- � . . .Ltcense�# . -
<br /> MECHANICAL` . • �, COAl1PANY '_� ` . � ' , �
<br /> SIGNATURE � • "`` ' ' �
<br /> �.. , .. ., . . .
<br /> � �� R . ISTEftED , ,,Y,/ N
<br /> ,EG � FEE•CURRE�, .. Y:/-N .
<br /> Address-" ' _ ,° � " ' � Cicense# ' � -
<br /> OTHER ' � � .. • -;COMPANY, �, ` _' .
<br /> SIGNATURE �. • �>>• ' ^ - • ' ' "' ' REGISTERED Y/ N.,.- �FEE CURRE� Y/N-
<br /> Address, ._ � - ' ' �� ' " - � ' � �License# _ . . ; � '� , ,
<br /> RESIDENTIAL;;; Attach'(2),;Plot P.,lan's;.(2)sets=ofBuilding�Rlans;(1)-set of Eneigy�Fortns;R=O=W�Perrriit for new constniction, '
<br /> ;, :,,� ;Minimum�tenr(:1.0).wo,rlcing,days�after„submittal'date.�:Required onslte;�Constiuctlon�Rlans,'StoRnwater Plans-w/SIIt�Fence installed,
<br /> SanitaryFacilfUes,:&:.19dumpster.•_Site;Worlc;PerrnitfarrsubiliVi5lons/large:prnjects.�__:-:_�:�- ' " " ` ' `
<br /> COMMERCIAL Attach(3)�eomplete sefs ofBuilding`Plans�pius�a�Ufe Safety Page;(1)set of Energy Forms.R-O-W�Permit for new construction. -
<br /> Mlnimum 4en(10)working days after submitt�al date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilides&1 dumpster.Site Work Pertnit for all new�projects:All commercial requlrements must meet camplience �
<br /> SIGN PERMIT Attacti(2)sets of�Engineered;Flans:�� •-, -. .�. ",= .� _ - -
<br /> ""PROPERTY SURVEY raquired for_all NEW_constructlon.. _ .
<br /> Directlon�: � .. - - - �
<br /> Fill out appiicatlon completely.
<br /> Owner 8 Contractor sign back of applfcatlon,notarized
<br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over 57500) , ,
<br /> „�:":Y:'T„'::' .
<br /> " Agent(for the cantractor)`or'Powe�of"Atfomey(fo�tFie ovmer)would be someone with��notarized�letter from owner authorizing same
<br /> OVER THE COUNTER.PERMITTING-- -•-,(Frontof�Application Only)-- � �
<br /> Reraofs if shingles Sewers Service Upgrades A/C.` 'Fences(PlodSurvey/Footage)
<br /> Drlvewaya-Not over Counter if on public roadways..need§ROW' '
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