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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> • Suilding Department r:�-
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<br /> Date Received _
<br /> • Phone Cantact for Permitting `• �ca"2
<br /> Owner's Name I7/`� �/! pwner PhQne Number � '��c��
<br /> Owner's Address Q Owner Phane Number
<br /> Fee Simplei7itleholder Name p Owner Phone Number � �
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<br /> Fee Simple�Titleholder Address
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<br /> JOB ADDRESS �p 7' LOT# E_��
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<br /> suao�v�sia�v ,��K,��l�� �aRce�.io� /�i'02 a 0 o a o .
<br /> a (OBTAINED FROM PROpERTY TAX NOTICE)
<br /> WORK PROPQSED e NEW CONSTR 8 ADDIA�T � SIGN Q � Q DEMOl.tSH
<br /> � INSTALL �REPAIR
<br /> PROROSED USE- Q SFR [� COlt+IM 0 QTHER '. f
<br /> TYPE`OF CCINSTRUCTION [� BLOCK • [� FRAME � STEEL Q
<br /> DESGRIPTI;ON OF WOROC 4 /� /�'"�✓
<br /> BUiF:i)ING'SIZE SQ FOOTAGE HEiGHT •��_�
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<br /> � } VALUATION`OF TOTAL CONSTRUCTION
<br /> BUI�DING � �
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<br /> QE�ECTRtGAL $ �� .._ �
<br /> AMP SERVtCE Q PFtOGRESS ENERGY [� Vtt.R.E.C.
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<br /> QPI.UMBING L._ �
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<br /> MECHANfCAL $ VALUATIQN OF MECHANICA�.tNSTAILATIQN
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<br /> QGAS Q FiQOFING Q BPECIAI.TY [� QTHEf2
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<br /> FINI5HED EL.00R EI.EVATIQNS �—� FLOOD ZONE AREA QYES NO
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<br /> �.Blitd.DER ; CORIIPANY _ _ . _ - - - - __
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
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<br /> Addre�s � License# � �
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<br /> :�'ELEG'fRt,G1AN , COMPANY
<br /> .. SIGNi4TURE REGISTERED Y/ N FEE CURRE� Y/N
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<br /> � Aidclress Liaense# �� �
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<br /> PC�INISER�$. CO{UIPANY
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<br /> SIGNATURE REGISTERED Y�/'N " FEE CURRE� Y/N
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<br /> . Addre�s • License# � �
<br /> `: MECHAIdICAI:. . .COMPANY , / � . � �»
<br /> �"SIGNATUREr' ' P'lLQr�J � REGISTEREp , Y N - EEE CURRE�
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<br /> Add�ess4i•- Gt/ O/ License-# ���!",�c�„�u •,
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<br /> :,.OTNERw '��,:.- � ` ' COMPARIY
<br /> �'�'SIGNATURE�:: —= REGISTERED Y/.N FEE CURREK Y/N
<br /> J�ddress: - • ' - - ' � License# � W �
<br /> '``^RESIDENTIAI._.:� �Attacti.(2}�:Plot"P.lans;`'(2}�sefs-of`Building-Plaris;{1•)`set bfi�Energy,Forrtis;R=O=W.Feiniit,for new.construction, : �' ,
<br /> _" �4�°.-�--� -• =-��,Minimum.=ten�_(1Q)y;w,,orking;days:afte�.subrriittal•date.'Requ'ire8`onsite;GonstnictiortPlans;Stormwater Plans w/Silt Fence installed,
<br /> �"X ' ,Y...^.P' ..a.. . .-.
<br /> �a., - ' Sanitary,Facilities,&�1�ilumpste,r•;a,Site.Wor.ic Permit far:'siabdivisionsiiarge`'piajeats�= - -
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<br /> :�;COAAMERGiAi. Attach(2)`comptete'sefs"of Bualding Plans plus a'L,+fe Safety Page;(1}set of Energy Farms.R O-W Permit for'new constructian.
<br /> � ' Minimum ten(10)working days after submittal date. Repuired onsite,Canstruction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanftaly FaciEitfes&9 dumpster.Site WorEc.Permit fo�-afl�new pro�eats,Alt cammercia!requ�rements must meet comptlance
<br /> ��SIGN'PERMIT Attaoh(2}sets:of;Engineered Plans::� ' - • �
<br /> *"""PROPERTY SURVEY requir,ed for.all NEW construction. .
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<br /> �`:"Di�ections: � ._.. . • '
<br /> '" Rill out.application completely. �
<br /> - O.inrner°&�Contractorslgn bac3c af applicatian,natarized
<br /> - If over'$2500,a Notice af Commencement is required. (A/C upgrades over$750q)
<br /> , "' AgenY{for''the cont�actor)•or Power of Attomey{for'ttie owner}woulif tie someone with notarized letter.from owner autharizing same
<br /> �'.;OVER.THE COUNTER,�PERMITfING ,. (copy of contract,required) ' �
<br /> `-;Re�aofs�if sliingles Sewers Service Upgrades AJC Fences(PIoUSurvey/Footage) _
<br /> Driveways-Not over Counter,if an public roadways..needs�ROW,•.� � -'-- . -. '�=.x- �,. _ , =,
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<br /> i �� .� i . „� � .-. , � `i:."710' ��
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