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��r,����� City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ` • Building Department .
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<br /> Data Racalved � Phone Contact for Permittin �� ��� ����
<br /> Owner's Name `� d7� /, Owner Phone Number UL�� ��` w�'!
<br /> Owner's Address /- � /�J�'� �/� ���j� Owner Phone Number � �
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address �
<br /> JOB ADDRESS �� � p2.� ,� �/Jr/ t! �, ������- LOT# �
<br /> SUBDIVISION � PARCEL ID# �� �.���`�'/.� �� ��/�
<br /> . . (OBTAINED FRCM`PROPERTYTAX NOTICE) - " �
<br /> WORK PROPOSED , B NEW CONSTR _ADD/ALT Q SIGN Q Q DEMOLISH
<br /> � INSTALL REPAIR
<br /> PROPOSED�USE Q SFR �] COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME [� STEEL Q
<br /> DESCRIPTION OF WORK ��r �� _lf � p- Q '� � �� �� �/(�
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> OBUILDING � VALUATION`OF TOTAL CONSTRUCTION
<br /> QELECTRICAL $ � AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QPLUMBING $ �
<br /> QMECHANICAL $ ���� VALUATION OF MECHANICAL INSTALLATION.
<br /> OGAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address Lfcense#
<br /> ELECTRICiAN COMPANY
<br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addres� License# -
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGIS.TERED Y/ N FEE CURREK Y/N
<br /> Address .License#
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<br /> MECHANICAL �J��' � � COAAPANY �✓7Q s' �/II�L��""%��V�J ;
<br /> SIGNATURE ���1 �%�l �✓J��L� REGISTERED Y./ N FEE CURRE� Y/N
<br /> Addreas '�'�"t l 1`�/ �� License# �� ��'�l���� ;<.
<br /> OTHER ,COMPI4Nlf
<br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N
<br /> Address License#
<br /> RESIDENTIAL Attach"(2)Plot Plans;(2),sefs.of�Bullding`Plans;(1)"set of Energy�Forrns;R-O-W.PerrnlE for new construction,
<br /> Mlnimum:ten°(10):v±rorking;days-after submittal date. Requlred onsite,ConstnicdomPlans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilltles;&�1:;dumpste_r,Site•Work�Permit forsubdiv.isionsAarge projects
<br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction.
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> - Sanitary Facilities&�1 dumpster.Site Work Pertnit for all new projects.All commercial requlrements must meet compllance
<br /> SIGN PERMIT Attach(2)'sets of Engineered�Plans. � -
<br /> "••PROPERTY SURVEY required for all NEW construc8on.
<br /> Dlrectlons: ' � , .. _.
<br /> FIII out applicatlon completely.'' _ �=�
<br /> Owner 8 Contractor sign back of appltcaUon,notarized '
<br /> If over�2500,a Notice of Commencement is required. (AIC upgrades over�7500) �
<br /> " AgeM(for the contra'ctor)or'Power of Attomey'(for,the owner)would be someone with notarized letter from_owner authorizing same,
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<br /> DVER THE COUNTER PERMIT;TING _..;(Front of.,Application Only)' i, - . � .. ;
<br /> Reroofs if shingles Sewers� , ,Service Up,grades A/C � `:Fences(PIoUSurvey/Footage) ,
<br /> Driveways-Not over Counfer ff an public roadways:.needs ROW 'I � ' •
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