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s�aaso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Building Department � �a.
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<br /> Date Received :"'
<br /> Phone Contact for Permitting ' — �
<br /> Owner's Name 1 �� 1 .�X ��e , Owner Phone Number 1 -
<br /> Owner's Address Owner Phone Wumber
<br /> Fee SimpleGTitleholder Name � � Owner Phone Number
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<br /> Fee Simple;Titleholder Address
<br /> � �JOB ADDRESS � O�S� LOT#
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<br /> SUBDIVISION PARCEi.ID# i
<br /> (OBTAINED FROM PROPERTY TAX NOTICE) - I
<br /> WORK PROPOSED B . NEW CONSTR B ADD/ALT Q SIGN Q � Q DEMOLISH �
<br /> i INSTALL REPAIR
<br /> PROP,OSED USE Q ' SFR Q COMM 0 OTHER .
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<br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRi4ME 0 STEEL Q i
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<br /> DESCRIPTfON OF WORK I�'�O l� T"6�C—� d - S�OC.k-��-Q I
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<br /> BUILDING 31ZE SQ FOOTAGE� HEIGHT •. �
<br /> QBUI,LDING $ �,0, � I
<br /> s VALUATION'OF TOTAC CONSTRUCTION �
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<br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. �
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<br /> OP;LUMBING $
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<br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
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<br /> QGAS Q ROOFING Q SPECIALTY Q OTHER j
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO -
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<br /> :BUILDER 4 _. COINPAMY ��� � �
<br /> � SIGNATU � EGISTERED �Y`/ N FEE CURREP. Y/N. .
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<br /> Addre�s �. tL. -License#
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<br /> ;:"ELECTRI.CIAN ,; COAAPANY ' i
<br /> :. SIGNATURE REGISTERED Y/ N FEE'CURRE� Y/N j
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<br /> Address - License# � � �
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<br />' PLi1MBER;E, COMPANY I
<br />' SIGNATURE _ REGISTERED Y•/'N, � FEE CURRE� � Y/N '
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<br /> Address • License# :� �
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<br /> I `'.MECHi4NICAL , _ COMP..ANY
<br /> � SIGNATURE' ' REGISTERED , 'Y/ N FeE cuR�� :, . Y/N :
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<br /> Add�ess�`� � ' ' " License.# '
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<br /> Y}:IS-W.-:P -.:. . .
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<br /> ," .OTHER���.:��; ' COMPARJY
<br /> `�SIGNATURE:i�;:_ .�r - • REGISTERED Y/.N FEE CURREK Y./N
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<br /> Address�y.�- �- . - Licerise# �
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<br /> "�<RESIDENTIi4L,�;. -�AttacF�;(2):Plot�;P.lans;�;(2)=sefs�of�Building�Plans;(1�)`set of'EneFgy:For`ms;R=O=W.Perriiif.foc new.construption,. � �
<br /> ,: n-�4��;�,�1;�:_�:Minimum_:ten�(;70)siniorking�days afte�sutimittal<date.�Reqiiired onsite;'Gonstruction-Plans;Storinwater'Plan's w/Silt Fence installed,
<br /> <.,•,.,. . � , Saqitary.�Facili6ese&�1�;dumpste�;_Site�Wor,ic�Rerrriit for subdivisions/large`projectsw .� ' � � ' " -
<br /> ��n.COMRAERCIAL Attach(2)'coriiplete'sets'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,.Stormwater Plans w/Silt Fence installed,
<br /> '=#�. ' Sanitary Facilities&1 dumpster,Site VUork Permit fo��all�new�projects.All commercial requirements,must meet complia.nce ,
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<br /> �<,SIGN�PERMIT Atta6h(2)sets:;of;Engineere.d�Plans:�r�=•- , - , ' ,
<br /> �.��.:;r . �R�*PROPERTYSURVEY,reguir,edfor�all.NEW construction: . , �
<br /> '�-Di�eations:> =,.,i-�,-,: :::: , ' �
<br /> - Fiil°ouf.application completely. ,
<br /> � O.wner:�&-Contractor sigR back of applicaGon,notarized '
<br /> - If over'$2500,a Notice.of Commencement is required. (A/C upgrades over$7500) _.
<br /> ,' *". AgenY(for�4h'e�contractor)ror�Power ofAttomey(for'ttie owner}woulil be someone with notarized letter ftom owner authoriiing same
<br /> i;�:OVER`:7HE�COUNTER�,PERMI]'I'ING. _.... ,.(�opy.of•contract�required) ' " " ,'
<br /> �Re�oofs•if sfiingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage)
<br /> = Driveways-Not over Counter if on public roadways..needs ROW -
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