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� 813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department '�
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<br /> Date Received - :�: P.,hone•Contactfor°Permlttin
<br /> Owner's Name �� ��z�'i! LJ Owner Phone Number
<br /> Owner's Address � �� � (1� �D� � I� Owner Phone Number
<br /> Fee Slmple�Titleholder Name �^ Owrier Phone Number
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<br /> Fee Simple lTitleholder Address �
<br /> JOB ADDRESS �J� ( �J U �.'Cl. l� LOT# ��
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<br /> SUBDIVISION � PARCEL ID# d�����^ � "�l� ����� ���D�
<br /> � . (OBTAINED F OM.PROPERTY,TAX NOTICE)
<br /> WORK PROPOSED. fVEW CONSTR ADD/ALT Q SIGN`` Q- � Q DEMOLISH
<br /> f •;e. INSTALL � : REPAIR -
<br /> PROPOSED=USE Q SFR Q COMM Q -OTHER - ' •
<br /> TYPE OF CONSTRUCTION Q� BLOCK ' Q FRAME Q STEEC Q '
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<br /> DESCRIPTIONOFWORK Q}C -eV� U� ��'Q� o�l- -2V'c'[C'e �'
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<br /> BUILDING SIZE � SQ FOOTAGE ,HEIGHT�
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<br /> [�BUILDING $ VALUATION'OF-TOTAI:'CONSTRIJCTION s "
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<br /> QELECTRICAL $ " y AMP SERVICE Q PROGRESS ENERGY [� W.R.E:C.
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<br /> QPLUMBING $ - '
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<br /> QMECHANICAL $ ' ' VALUATION OF,MECHANICAL INSTALLATION ��
<br /> QGAS Q ROOFING .Q SPECIAL7Y � � OTHER - �j� �" -
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES :NO ��
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<br /> BUILDER � COMPANY�' ' = �' �"
<br /> SIGNATURE REGISTERED Y/ N 'FEE cuR�� ' Y/N
<br /> Address Llcense# '
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<br /> ELECTRICIAN: -COANPANY �'
<br /> SIGNATURE � REGISTERED Y/ N FEE CURR ` ='Y/N
<br /> Address ' , � _ ,_ Llcense# G`-��0� �.
<br /> PLUMBER ' -COMP.ANY � �
<br /> SIGNATURE • ' , ,REGIS7ERED. > Y/,�N ;FEE CURRE� , Y�/N �- '
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<br /> Address ' .� � ' .LI'oenseJ#� � _ � " -
<br /> MECHANICAL' ' COMPANY - � °
<br /> SIGNATURE ` �' ` REGIS7ERED., .Y/.N. , �,FEE+CURRE�: � Y-/�N �
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<br /> Addre�` • . . : _ . _ � ` . , � �, , , � i License# _
<br /> OTHER � - ' _ � � '�COMPANY `" , - ` ' .
<br /> SIGNATURE ,. � `" � " " - � ` � `RE�Is7E�o Y/ Ns.: ' �E CURi�n Y/N
<br /> Address , _ . . � � _� Llcense# . ' ,-� .
<br /> RESIDENTIAL_�:�.. :Attach'(2),Plo.t-P,lans;;(2)sets..of�Builiiing�Plan"s;�(1)sefof'Energy>Forrns;�R�O=VV�Perirlitfor.newconstruction,.. �
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<br /> •- � �*:Minimum;tenr(1�,U)+,�working,d'ays=after,„submlEfal'date::.Requlred onsife,�.Constivodon:Plans;'Stortnwater`Pians w"'/SIIYFence installed,
<br /> � ���' Sanitery FaciltUes;&,,1�dumpster�Site-Work;Permitfor:sutidiVisions/iarge�projeofs... ;.�-- ' ' • '�
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<br /> COMMERCIAL Attach(3j�cbmplete sets of 8uildirig Plans plus a'Ufe�$afety Page;(1)set of Energy Forms.R-O-W Permtt for new constructlon.
<br /> Minimum ten(10)working days�after submittal date. Required onsite,ConsUuction Plans,Stortnwater Plans w/Silt Fence fnstalled,
<br /> Sanitary Facilitles&1 dumpster.Site Work Permit for ali new!projects:All commerdal requirements must meet campllance -
<br /> SIGN PERMIT Attach"(2)`sets ofEnginee[edcPlans:;.,� ;^-' , � � ,
<br /> "•'PROPERTY SURVEY reguired for al,l NEW construcdon..
<br /> Directlons: . . - � '
<br /> Ffll out applicatlon completely.
<br /> Owner 8 Contractor sign back of appl(catlon,notarized
<br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over ST500) ,
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<br /> " Agent(for the i�ntractor)or Power of Attomey�(for tFie owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITrING --, (FronEof-Application Only)- � � '
<br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlotlSurvey/Footage)
<br /> Drivewaya-Not over�Coynter.if on;�public'roadwaqs..need's ROW
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