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aasasaoo2o City of Zephyrhills Permit Application Fax 813-780-0021
<br /> � ' �uilding Departrnent - �
<br /> Date Recelved � Q (¢ � , ° Phone�Contact for Permittln � � �� — � S 3�
<br /> Owner's Name N Owner Phone Number
<br /> Owner's Address '"f'-7 3S �s(!V e cK 11�� • Owner Phone Number
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<br /> Fee Slmpls,TltleFiolder Name Own�r Phone Number -
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<br /> Fee Simple;Titleholder Address �
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<br /> JOB ADDRESS � `C"�3� S�`I��'''� � � • � LOT# ��
<br /> SUBDIVISION PAItCEL ID# I S � �-� `oZ-� ����0 �� v o � — p / 5�
<br /> � � (OBTAINED F,ROM.PROPERLY,TAX NOTICE)
<br /> WORK PROPOSED , NEW CONSTR ADD/ALT Q SIGN� `Q �Q DEMOLISH
<br /> � INSTALL � REPAIR -� � -
<br /> PROPOSED:USE � SFR Q COMM Q �OTNER '
<br /> TYPE OF CONSTRUCTION ' BLOCK ' [] FFtAME �� Q� STEEL Q
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<br /> DESCRIPTION OF WORK �S '
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<br /> BIJILDING SIZE'- � SQ�FOOTAGE � �.3 ; ,.HEI,GHT��_._ �
<br /> QBUILDING $ �3� VALUATIOIV'"OF`TOTAL CONSTRUCTION
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<br /> QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E:C.
<br /> QPLUMBING � `$ � '
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<br /> Q MECHANICAL � $ VALUATION OF;MECHANICAL INSTALLATION �q Q��
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<br /> QGAS Q ROOFING .[1�SPECIALTY-Q OTHER -
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ��,.NO
<br /> BUILDER ; COMPANY-� � '-""
<br /> SIGNATURE REGISTERED Y/ N FEE CURREP' Y/N
<br /> Addres� Ltcense# � ' � �
<br /> ELECTRICYAN: .�COMPANIf ' ' ' �
<br /> SIGNATURE � REGISTERED Y/ N F�cu�n�� ''�Y/N `
<br /> Address ' ' . License#. - ' y
<br /> PLUMBER'_ , = COAAP:I4NY ; ;' � _�
<br /> SIGNATURE� � � _ REGIST.ERED< Y-./,.N . � •;FEE CURRE� ' Y/fV .
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<br /> Address ` , � - . , .License„# �T � w, -
<br /> MECHANIC74L" � � COM,PANY.. ' , . � � ' •
<br /> SIGN14TUIZE � ' " � REGIS,TERED Y,/ N. _„, ,�,, FEECURRE��- . Y��/�N =
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<br /> Address `: , , . � , - . ' � • ` - . � , License#� - ,
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<br /> OYHER '.` . ., . -,. _ , " `' � ,,COMPANY�� � ±. �. .... .
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<br /> SIGNATURE '=� �� i - ' ' REGISTERED ` Y/ N:... FEE CURRE_ ` Y/N
<br /> Addre�s ��D_.:_ X�F ' - .r:��' ` Ucense# C�- � �t'Z
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<br /> RESIDENTIAL;.,�;: Attach'(2)„Plot�.Paans;'•,�(2)sets'•:of BuilBing�'Flans;(1)set of Ertergy�Foim§;'�R=0=1N:Perrrilf fbr new conshuction,,, ' -
<br /> ; r,3"-;fNinimum ten(10)woricing;dayg_after„subriiiftal date�:Requi�ed onsite Co`n§trucdon°Plans;Storrnwate�Plens w%SIIt�Fence installed, '
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<br /> SanitaryFaciltttes.&;�1kgdu,m.psterTSite'�IVorIc,�P,ermit�farsubtlivisiohs/lafge'projeots�_,,..,":;.;� �_ - - � �
<br /> COMMERCIAL. Attach(3)`comple4e'sets`ofBuilding Plans plus a Life Safety Pege;�(1)set of Energy�Forms.R-O-W Permit for new construc4lon.
<br /> Minimum ten(10)working days after submittal date. Required onsite,ConsUucNon Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facflitles 8�1 dumpster.Site Work Permit for aII new.projects:.All commercial requirements_must meet compliance�
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<br /> SIGN PERMIT AttacFi(2)"sets'ofEngineer,edyPlaris:;:�,:-��,° .. � ::� ....� ' : , �-
<br /> ""PROPERTY SURVEY required for,all�NEW_const[uction.., •
<br /> Directlons: . �.=�x�. � .- ,, :..
<br /> Ftll out applicaUon wmptetely.
<br /> Owner&Contractor sign back of applfcaUon,noharized
<br /> If over 52500,a Notice of Commencement la r�quired. (AIC upgrades over 57500) , ,
<br /> " Agent(for ttie contraotorj`'or'Powe�of AtEomey(for ttie owner)Fvuould be someone with'nota�ized letter from owner authorizing same
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<br /> DVER THE-COUNTER,PERNIITTING=- .--�-�(Front of-Applicetion Only)�"' � �-
<br /> Reroofs if shingles Sewers Service;Upgrades ,NC Fences(PIoUSurvey/Footage) _
<br /> Drivewaya-Not over Counter if an public roadwiays..needs ROW. �
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