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a93asaoozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> Building Departrnent � �
<br /> � * �J ,rfCL
<br /> Date Received � � 7�(p 59� _ jz�� / 7�7
<br /> ?� Phone>Contact�for:Permlttin
<br /> Owner's Name P1 Z{TF{ �Lo�T Z Owner Phone Number
<br /> Owner's Ad;dress 3?g Z�� W ���''`�`I A� � Owner Phone Number �
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<br /> Fee Simple iTitleholder Mame � Owner Phone Number
<br /> Fee Simple;Tltleholder Address
<br /> JOB ADDRESS .A Nt� �o t)d'e LOT# �
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<br /> SUBDIVISION PbRCEL.ID#
<br /> , , . ,, (OBTAINED FROM.PROPERTYTAX NOTICE)
<br /> WORK PRO,POSED „NEW CONSTR ADD/AI:T Q SIGN� Q �Q DEMOLISH
<br /> � INSTALL B � REPi41R
<br /> PROPOSED�USE - Q SFR Q COMM Q OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK " Q FRAME �Q STEEL 'Q
<br /> DE3CRIPTION OF WORK' rv S i`e� � �' 1 �
<br /> BUILDING SIZE 2`'I X l Z— ' SQ FOOTAGE 'Zg� ,HEIGHT � ��� r
<br /> [�BWILDING $ (e`J�� VALUATION: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 /> QMECNANIGAL $ VALUATION OF;MECHANICAL INSTALLATION �
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<br /> QGAS Q ROOFING Q SPECIALT,Y.�_,' ,_ OTHER- � �
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO _
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<br /> SIGNATURE j��""'"�� �I�„ ��� R OMPANY" ` I Y/ N FEE CURREA Y/N
<br /> Addre�s � ' Cicense#
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<br /> ELECTRICIMI � � : COMPANY �
<br /> SIGNATUitE � REGISTERED Y/ N FEE CURRE�•' -Y/N
<br /> Address - , � _ License# .
<br /> PLUMBER � _ COMPANY ;;," � . � ,
<br /> SIGNATURE' .� . _REGISTERED,, Y./,'N: .-FEE�CURRE�' Y�/N `
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<br /> Addre�s , . , i. . _ � � License:# . ,
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<br /> MECHANICAI: COM,PANY I .�_,u,.:. '• , .� J,r , . . .. '
<br /> SIGNATURE- ' ' " " " � � ' -
<br /> REGISTERED �� Y,/.N. ' ,„FEE CURRE�,. ��.:,Y./•N �
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<br /> Address�- � ` _- ' ' ' L'icense#I� .-
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<br /> OTHER f' � ` tz3 � , , ' '
<br /> ' :COMPANY _ _
<br /> SIGNATURE " _ � • • ' ` �RECISTE�o' � Y/ N._: ,� �E Cuw�En Y/N
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<br /> �f = , -,
<br /> Address � • � � Cicanse# �
<br /> RESIDENTIAL,-�. Attach�(2�),Plot�:Plans;,(2)sets:of�Buildfng"Plan's;(1)'sef of-'Energy�Foirn§;��R-0=1N'Pertnit for new construction, � - �
<br /> - _ Minimum;ten,(:10)::;worktng;days aftee'submittalilate:i Requlred onsite,:Con'stiucdon Plans;Stortnwater'Plan`s•w/SIIt Fence tnstalled,
<br /> � �� �Sanitary FaciltUes;8��1•dumpster,•SIte.Worlc;Permitforsubdivisio�s/large:projects.� �,- " �� ' � '�
<br /> COMMERCIAL Attach(3)�oomplete sets of Builtling"Plans plus a�Life Safety Pege;(1)set of Energy Forms.R-O-W Permit for new construcdon.
<br /> Mlnimum ten(10)working days after submittal date. Requtred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary FaciliUes&1 dumpster.Site Work Perm14 for all new',proJects.All commercial requirements must meet compllance-� �
<br /> SIGN PERMIT AttacFi-(2)sets ofEngtneer,ed:Plans.. . ' °• . , - • -
<br /> ""'PROPERTY SURVEY reguired for all NEW construcUon.
<br /> Dlrectlons: : - � , � _
<br /> Fill out applicatlon completely. '
<br /> Owner 8 Contractor sign back of applfcatlon,notarized
<br /> If over b2500,a Notice of Commencement la required. (AIC upgrades over a7500) ,
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<br /> " Agent(for the contractor)or Power of Attomey�(fo�ttie�owner)would be someone with notarized letter from owner authorizing same
<br /> �VER THE COUNTER.PERMITTING -, {Front of Appilcetion Only)- - � ' " � -
<br /> Reroofs if shingles Sewers Service Upgrades:A/C �� -Fences.(PlodSurvey/Footage) - . � � � '
<br /> Driveways-Not over Counter ff on public roaduvays::need's ROW� ' , - , , , ,
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