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.813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � R Building Departrnent -
<br /> Date Recelved ��3 �� - � 3 -
<br /> Phone=ContactforPermlttln '
<br /> Owner's Name �e�oC.� �ui o Owner Phone Number
<br /> Owner's Addrass �� 2� o Owner Phone Number
<br /> Fee Slmple,Titleholder Name Owner Phone Number '
<br /> � -
<br /> Fee Simple�Titleholder Address �
<br /> JOB ADDRESS Co� 2-� O �t..3 / � j' LOT# �
<br /> SUBDIVISION PARCEL ID# � O - �o —Z� -O 23 O -�O O p �J .— �J� �O
<br /> i , (OBJAINED FROM PROPERTYTAX NOTICE)
<br /> WORK PROPOSED NEW CONSTR ADQIALT Q` SIGN .,"Q � 'Q DEMOLISH
<br /> --e INSTALL B REPAIR �� �
<br /> PROPOSED:USE � Q SFR. Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q" � 'BLOCK ' Q FRAME [� STEEL` Q
<br /> DESCRIP7I,ON OF WORK � �l �naS� S
<br /> i , .
<br /> BUILDING SI2E SQ FOOTAGE '��Q�S , HEIGHT F M1
<br /> [�BUILDING $ ' �Z$,�- VALUATION"OF TOTAL CONSTRUCTION" h `~
<br /> ,
<br /> QELECTRICAL $ . " AMP SERVICE Q PROGRESS ENERGY Q W.R.E:C.
<br /> QPLUMBING �$ '
<br /> i ' ���
<br /> QMECHANICAL $ - VALUATION O.F MECHANICAL INSTALLATION. � 1�
<br /> QGAS Q ROOFING .� SPECIALTY Q OTHER�
<br /> FIIVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO
<br /> BUILDER COMPANY -
<br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y'/N�
<br /> Address - Llcense# �
<br /> �
<br /> ELECTRICIAN- ,. COMPANY
<br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE��' 'Y/N `
<br /> Address ' � , . : �. � _ _ License# ,
<br /> PLUMBER` , � -• COMPANY - - ' �
<br /> SIGNATURE ' �REGISTERED �Y/.,.N. : L;FEE CURRER ' Y-/N . .
<br /> Address ; � � . .:License�#, - • �
<br /> MECHANICAL` ' � ' COMPANY, '
<br /> . ;� , , z , -� , . . � ..._. _ .
<br /> SIGNATURE� ^ REGISTERED Y./ N. , _ . FEECURRE�- Y�/�N -
<br /> z .
<br /> Address ''�-: ', ' . _- ` • _ ' License#
<br /> �. . .
<br /> OTHER ; _ � - (� )� � p' � � ;COMPANY ,. � - , �, ,
<br /> SIGNATURE ,+ "'" `" ` { ' RE� ISTERED
<br /> � ''�'""'\ G � Y/ N ._ FEE CURRE� Y/N-
<br /> Address �t,�',7-��; _ - _ � Ucense# C C�--p S�l`1�Z . '
<br /> RESIDENTIAL;f�-: �AttacFi;(2)�P1ot�P:lans;:(2)sets.of:Building',Plan's;'(1)'sefof-Energy�Forins;�;R=O=W`Pertnitfornewconstruction,. � ' �
<br /> _r,�Mi.nimum;ten;(�10):�uqo.rliing;days'after;submitital date.�,Required onsite;.'Ctinstnic8on Rlans;`Stortnwater Plans w/SOf�Fence installed,
<br /> �Sanifary FacllfUes;&x1<,dumpster�Stte�Worlc,;Permltfo[`subdivisions/large.pro)ects;�.. ;'.,;._ �" ` `' '
<br /> COMMERCl/4L Attact�(3)-complefe setis of Building�Plans plus'a�Life Safety Page;(1)set of Energy Fortns.R-O-V11 Perm(t for new construcUon.-
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for all naw:projects:All commerGal requlrements_must meet compllance' '
<br /> SIGN PERMIT Attach(2j"sets�of Engineer,ed.Plans:;-.�-.;�-•�" .• �, , �
<br /> "'•PROPERTY SURVEY required for aII,NEW gons.Uuctlon.._
<br /> Directlons: , . � = „ `
<br /> FIII out appllcadon completely.
<br /> Owner&Contractor sign back of applfcaUon,notarized
<br /> If over�2500,a Notice of Commencement i�requlred. (AIC upgrades over 57500)
<br /> .. �r::.•...,�-._ - -
<br /> Agent(for the contractor)or'Powe�of Attomey(fo�ttie ovmer)would be�someone with nota�ized letter from owner authorizing same
<br /> DVER THE COUNTER.PERMITTING�- -.--,-(Front of-Application Only)
<br /> Reraofs if shingles Sewers ' Service Upgrades A/C Fences(PlodSurvey/Footage)
<br /> - - -- - _ _ _.. . .. _ ..�. : .. . -
<br /> Driveways-Not over Counter if on public roadways..need`s ROW ` �
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