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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department ,
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<br /> Date Received , � s,•.�
<br /> PhoneContactforPermitting �
<br /> Owner's Name � � Owner Phone Number 4 �� �� %'��"I
<br /> Owner's Address 7 7� �1��� � Owner Phone IVumber
<br /> Fee Simple Titleholder Name P Owner Phone Number j
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<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
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<br /> SUBDIVISION 4/O'!'' �i� PARCEL ID# '
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<br /> , F (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED B . NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH ,
<br /> � INSTALL REPAIR '
<br /> PROP.,OSED USE Q SFR Q CONIM 0 OTHER �/ 3 ,�� ��.� I
<br /> TYPE:'OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q
<br /> DESCRIPTION OF WORK U�'' C'1QL' + " 1 S/ C'/�'� /1�� OvTI�
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<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT • i
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<br /> QBUILDING $ '
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<br /> VALUATION'OF TOTAL CONSTRUCTION
<br /> ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY � W.R.E.C.
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<br /> QPLUMBING $ �
<br /> Q ,MECHANICAL
<br /> $ VALUATION OF MECHANICAL INSTALLATION ���Ti��
<br /> QGAS Q ROOFING Q SPECIALTY Q Ol'HER
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<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO
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<br /> BUILDER ; COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Addre'ss License# '
<br /> ELECTRI,CIAN COiUiPANY ��� � �� G�`��T�'Zrt
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N. ' �
<br /> - adaress` �`✓��d 1_��� C , License# �cI�BQ�� '
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<br /> P.LUMBER.�., , COMPANY � I
<br /> �SIGN�►TURE RE��sTeREo � Y-/ N FEE CURRE� Y/N
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<br /> Address � License#
<br /> ', .MECHi4NICAL COMPANY
<br /> SIGNATURE" REGISTERED , Y/ N FEE CURRE� ,. Y/N
<br /> Ad'd�ess��` � License.# I
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<br /> _ ATHER`� "'; C,OMF?ANY �
<br /> ="SIGNATURE�;r E_ ,• � � REGISTERED Y/ N FEE CURREK Y/N
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<br /> a:�f: ::�" ,< <. . .
<br /> Address,�:.; - � License#
<br /> r��RESIDENTIl4L>,�: Attach:(2)4PIof;Plans;'(2):sefs'of�Builiiing-Plans;T(1)'set ofEnergy FoRris;R=0-1N.Pemmiit�or new.construction, ;
<br /> ' T-,:;�;;u�y,:��,:,Minlmum,ten;(�1Q)working;days:afte�su6mittal:date.:Required'onsite;Gonstriiction Plans;Stormuvater�Pla�s w/Silt Fence.installed,
<br /> •• J� Sanitary Facilities,&;,1�dumpster;,S„ite:Wor,k Permit foe.subdivisions/large'.p�ojects�- ° �
<br /> I- �{�GOII�MERCIAL Attach'(2)`complete�sets of�Builiiing'Plans�plus a Life Safety Page;(1)set of Energy Forms.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 FaciliBes 8 1 dumpster.,Site Work Permit fo�all new projects.All commercial requirements must meet compliance '
<br /> ��-•, ., .� .
<br /> �.�SIGN°.PERMI7 Attach"(2)sets.of;Engineered'Flans:,r• ,- -. � '
<br /> _- � "'"PROPERTY SURVEY required for a11.NEW constrvctlon.
<br /> ";Diiections•� •. _ . ,. ,.
<br /> ��FIII':out:application completely. �
<br /> __ =0virner&Contraotor sign back of appl(cation,notarized ,
<br /> , If over�$2500;a Notice of Commencement is required. (AIC upgrades over$7500) �
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<br /> ."' A enY forth'e�cont�actor ror�PoweroYAttome for the owner would be someone with notarized letter from owner authorizin same
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<br /> ^-:�OVER:THE COUNTER�PERMITTING. _. (copy.of-contract required) I
<br /> �Reroofs.if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
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<br /> � Driveways-Not over Counter if on public roadways..needs ROW _ �
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