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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 Receiyed �� phone Contact for Permitting � �ri7 �G� — � � �•`� `
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<br /> Owner's Name ' C - � ! -o( r Owner Phone Number ,'
<br /> Owner's Address . /� .� /v . ��
<br /> ' Owner Phone Number
<br /> Fee Simple Titleholder Name ��� " �l Owner�Phone Number ,
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<br /> Fee Simple Titleholder Address
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<br /> JOB ADDRESS �Q� / �� � / �t [ �G LOT#
<br /> SUBDIVISION PARCEL ID#
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<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br />, WORK PROPOSED � B . NEW CONSTR e ADD/ALT 0 SIGN Q � Q DEMOLISH
<br /> � INSTALL REPAIR
<br />�I PROP,,OSED USE Q SFR Q COMM Q OTHER `
<br /> TYPE`OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q �
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<br /> DESCRIPTION OF WORK y - rF� �-Yt�'�' � `f 0 7 �� '�
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<br /> BUILDING SIZE SQ FOOTAGE� HEIGHT •
<br /> QBUILDING $ � � VALUATION"OF TOTAL CONSTROCTION
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<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C.
<br /> QFLUMBING $ ���
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<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
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<br /> Q,GAS Q ROOFING Q SPECIALTY Q OTHER
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<br />� FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO
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<br /> BUILDER ( COMPANY •L. � G;,i� � �i�t'rl4� J� `'?�dlG
<br /> SIGIdATURE i� REGISTERED Y/ N FEE E� Y/N , '
<br /> Address , UL =, �Q��a- � �L �� , License# C a l ,Z.
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<br /> �"'ELECTRI,GIAN i.. COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N.
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<br /> Address License# �
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<br /> PLUA6BER; COMPANY
<br /> SIGNATURE REGISTERED Y>/`N'. FEE CURRE� Y'/N
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<br /> Addre'ss License#`
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<br /> "'.MECH)4NICAL � , COMPANY
<br /> "�SIGNATURE" � � REGISTERED , Y/ N FEE.cut�e� Y/N
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<br /> Add�e'ss'��� � � Licens,e.#
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<br /> :;.OTHER- ��-= ` COMP�ANY �
<br /> `SIGNATURE:�.1 a - ' RE�isTEReo � Y/.N FEE CURREK Y/N
<br /> Address,, �� License#
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<br /> �;:`RESIDENTIAL:�;u�, :Attacti�_(2)�PIot:Plan`s,':�2)"setsof�Buil'ding'Plans;T(1•)`sef ofEnergy`Forms;R=O=W Permft,fo�new.constiuction,
<br /> - ,: ��,�V���:.:t.,.�,��.�Minimum,�,ten�(,10)wqrkingf.cJays after sutimittaladate. 'Required'orisite;Gon`strucfion Plans,'Stormwater Plans w/Silt Fence installed,
<br /> < ...�,.,��:...,_u ,_ ..
<br /> ; Sanitary;Facilities;;&�1�dumpster;�Siter;Wor,ic.Permitfoe;subdivisions/large`.p�ojecfs�- �
<br /> ,-r.COMMERCIAL Attach(2)compleCe"sefs-of�Builiiirig 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,Stortnwater Plans w/Silt Fence installed,
<br /> ;;:. San(tary Facilitles 8�1 dumpster.Site Work Permit fo�all-new•p�ojects.All commercial requirements must meet compliance
<br /> '=SIGN°,PERAAIT `AtfaoFi(2)�sets;.of,Engineered`Plans.�=� '
<br />' k`""=�- " "••*pROPERTY SURVEY requfred for,.aII.NEW construction.•.
<br /> c`:Dl�ectlons:; r.,,i.•::-��;. ... .
<br /> ` � �� Fill<out�application completely.
<br /> y__ Owner;&Contrattor sign back of application,notarized �
<br /> , If over;$2500,a Notice.of Commencement ls required. (N,C upgrades over$7500) ,
<br /> .,*�. ' Y,i:T'„ �
<br /> •, _ Agent�(fo�`tlie`°conVactor)�orPower of Attomey(for'the owner)would be someone with notarized letter from owner authorizing same
<br /> ';.,OVER;THE'COUNTER:PERMI7TING. (copy.of contractrrequired) � ' �
<br /> ' :Rer6ofs if sliingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-Not over Counter if on public roaiiway§..needs ROW
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