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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �
<br /> • Builcling Department 7';�
<br /> Date Received .'
<br /> � Phone Contact for Permitting �
<br /> Owner's Name ,l� Owner Phone Mumber b � ���^ ��"
<br /> �y- ,,._. �
<br /> Owner's Address ,��b � ' - Owner Phone Number �
<br /> Fee Simplei7itleholder Name � � Owner Phone Number �— �
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<br /> Fee Simplei fiitlehalder Address
<br /> JOB ADDRESS ���I C7 /�'�... LpT# C____�
<br /> SUBDiViSiON � � PARCEL 1D#
<br /> j (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WQF2K PROPOSED ° e t�EW CONSTR 8 ADD'1A�T � SIGN Q � Q DEMOI.ISH
<br /> i INSTALL 'REPAIR
<br /> PROP.QSED USE Q SFR Q GOMM 0 4TliER
<br /> TYPE"OF CONSTRUCTION C] BLOCK • Q FRAME � STEEL Q
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<br /> i � �--,ry
<br /> DESCRIPTI,OTd OF WORK ' / G/ ^
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<br /> BUILDING SIZE $Q FOOTAGE�� . HEIGHT �� �
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<br /> ������t�� � 1'" � VAI.UATtO1V'OF TOTAL COIVSTRtJCTION
<br /> f L_
<br /> QEE.ECTRICAL $ ANtA SERVICE � PROGRESS ENEt2GY Q W.R.E.C.
<br /> �
<br /> OPI.UMBING �> �
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<br /> �MEGHANtGAL $ � � � VP�UATI4N OF MECHANICAL INSTALlfiT10N
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<br /> QGAS Q RQQFti�lG Q $PEGIALTY Q QTHER
<br /> FINISHED FLOOR EI.EVATIONS ��� FLOOD ZONE AREA QYES NO
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<br /> =.BUIl.DER i COMPANY
<br /> SIGNATUR� REGISTERED Y/ N FEE CURRE►� Y/N
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<br /> Address Llcense# � �
<br /> ; 'ELEGTRICl�AN �. CdMPAF1Y
<br /> SIGNATURE REGISTEREp Y/ N FEE CURRE� Y/N.
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<br /> - Address � License# �� $ �
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<br /> PCUMBER� GOIIAPANY
<br /> SIGNATURE REGISTERED Yr/'N. ` FEE CURRE� Y/N
<br /> Address
<br /> � License# � �
<br /> '�} ` - ��e�'`�
<br /> ; MECNANICA[: � COMP.ANY
<br /> " SIGNA9'URE"'" � REGISTERED / N -- = FEE CURRE� : Y/N � -
<br /> Address" � ' ' License# �! ��
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<br /> .: OT1�(ER" ," �
<br /> , ` COMPAtVY .
<br /> °"�SIGNATURE.:.,. � .�� - . ' ,
<br /> REGISTERED Y/.N. FEE CURREK Y/N
<br /> Address,: __ , , . � . Licsnse# �� � �
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<br /> :"l2ESIDENTI+A1.���_` :Aftach=:2,;Plot�P.lans;;2 k"s`efs�of�Building�Pians;(1,}�set af-E�ergy�Forms;R;O=W Permit.for new.constiuction,. �
<br /> :....� , .. - �, .
<br /> . �y-.-;�;- ;�;,,f-,,;Minimum�:ten;(.1Q).wocking;days.aftersubmittal:tlate.�Required onsite;Gori`strucUon Plans;Stormu'vater Plan"s w/Silt Fence installed,
<br /> �;:>. - ` .�'' � Sanit�ry,Fac111ties,8u-1�;dutnpster;ySite;Wor,k Permit forsubdivis{onsilarge''proJects - ' � � . - —
<br /> :�-.:GOMIIAERGIAl. A#tach-(2)'�comptete sefs'afBiiiliiirig Ptans ptus a�Life Safety Page;(t}set of Energy Porms.R-O-W Pertnit for new constructian.
<br /> • , Minimurti ten(10)working days after submittal date. Required onsite,Canstruction Plans,Storrnwater Plans w/Silt Fence installed,
<br /> �:':.;_ Sanitary Fac�llSes&9 dumpster.Site Wotk Pert»it fo��al!-new projeats.Atl commercia!requ�rements.myst meet cotnpliance
<br /> �r:„SiGN.PERMtT "Attacfi 2"sets.of_.'En ineered�Plans:-t--� �
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<br /> � ) .�_ `_,y9
<br /> 's,:~��°; PROPERTY SURVEY,requir,ed for.all,NEW consUvation:..
<br /> y:r:; - - - - _
<br /> ':Directions: r .. , „ - r. ,
<br /> �Fill out,application completely. ,
<br /> Owner'&Contractar sigt�back of application,notarized
<br /> , lf over:$2500,a Notice af:Commencement is required. (A/C upgrades over$750p)
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<br /> .�`"'' Agent(fo�'tfi's''�contractor)�or°Power of`Attomey{for"tkie dwner)would tie someone with no#arized letter from owner authorizing same
<br /> ;;;�OVER;THE COUNTER�PERMIITINCa> ,(copy_of contract-required) "
<br /> ;-°Reroof's if sFiingles � Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> Driveways-NotaverCounterifonpublicroadvirays..neecisROW: - ,,.,. ,,_,u,,�:-3�.__:,:n,.. --��• �-••_;,°
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