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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021
<br /> Building Department
<br /> Date Received - �3 c3
<br /> Phone"ContaitforPermittin -` '•(3 f ?c3 — c��
<br /> Owner's Name S Owner Phone Number .
<br /> Owner's Address -/" � '�J~�' - OwnsrPftane-Numtisr '
<br /> Fee Simple Titleholder Name Owner.Phone Number''
<br /> Fee Simple Titleholder Address "
<br /> JOB ADDRESS cZ !�7 CS�� LOT#
<br /> SUBDIVISION W PARCEL ID0'
<br /> (OBTAiNEo FRom PROPERTY TAx�'mo IcE)` -
<br /> WORK PROPOSED ^ NEW-CONSTR ADD/ALT SIGN` [ 0 t DEMOLISW
<br /> INSTALL .:REPAIR
<br /> PROPOSED',USE.. 0 SFR COMM ` "OTHER .I
<br /> TYPE OF CONSTRUCTION, Q '.:BLOCK 0 - FRAME STEEL_ .C]'`
<br /> DESCRIPTIWOF WORK
<br /> BUILDING,SIZE'.'= SQ FOOTAGE C� f ;HEIGHT.-
<br /> 1 :t.
<br /> E71
<br /> BUILDING - � L'C ,,;:•,_._.-
<br /> f VALUATION aF"TOTAONSTRUCTION
<br /> =ELECTRICAL $ AMP SERVICE ' PROGRESS ENERGY [�, 'W.R.E.C..
<br /> =PLUMBING It
<br /> =MECHANICAL $ VALUATION:OF MECHANICAL:INSTALLATION
<br /> [ GA' Q - ROOFING:::Q SPECIALTY-,= OTHER`
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES, NO.
<br /> BUILDER - _ / - COMPANY
<br /> SIGNATURE (/✓ REGISTERED YY N FEECURREh' Y
<br /> Address License'#
<br /> ELECTRICIAN; COMPANY`' _
<br /> SIGNATURE " REGISTERED Y/ N FEE CURREIS.
<br /> Address ._ ,. ••License'#;F
<br /> PLUMBER, COMP..ANY4_.:,'-,a
<br /> SIGNATURE'` REGIS.TEREO rY/,N,. FEE!CURREA' Y/N:
<br /> Address lJcense#
<br /> MECHANICAL' ,COMPANY
<br /> SIGNATURE '` ,.REPIsTEREa. Y;/:N::- -_FEE:CURREA Y/-N:: :,:. ....
<br /> •
<br /> y .. .. . ,-c ..
<br /> Address.::. :::_. License#;
<br /> OTHER PAW
<br /> SIGNATURE,. REGISTERED
<br /> Address +License#
<br /> RESIDENTIA_1: '° ttabh t2;P1ct Plans�}((2\\sets c►f Buildings"Ptaris;' 1 soti.itf Energy Foirris;f2=t7=ViC°.Perin'it'fgr,iieuy car structon.,:;:,
<br /> Inimuin?,ten: 10 wo I t da s after`sutimlttalydate:`R ulred onsife; _ ��f `tivcUon,,, s'w/S
<br /> °µ-,�(: ),w;,•rk. ,g;- ,y�-,. "�' r; eq ..: Cons � .ans;}Stormwater.Plan IltFencean'stalled,,
<br /> Sanitary FagllUesBal�ctumster,,SlferWork;Perrrtlt:for..sutidf5lldrisJlarg `pciojects : ;=
<br /> COMMERCIAL Attach(3)c bmplete'sets kif'Suitding Plans plus a`Life Safety Page;(i)set of Energy-Forms.R-O-W Permit for new constructlori:
<br /> Minimum ten.(10)working days after submittal date. Required.onsite,,,Constructlon Plans,Stormwater Plans w/Silt Fence Installed,.,,
<br /> Sanitary.Fadiitles_ W en: _ m ecti A!Fcommerclal requirements must,meat compliance
<br /> SIGN:PERMIT Attac#i'(2)'sets of Enginjaered
<br /> ""PROP.,ERTYSURVEY:required fprall:NEW cogstrucyon.;..,..:,.:..._
<br /> oiPeatlone: ::, : . '
<br /> Fill out application completely, 1
<br /> Owner S Contractor sign.badcof applicatlon,'notarized
<br /> If over$2500,a Nottoe.of Commencement is required. (A/C upgYndes aver S7S00)-
<br /> Agent(for tti®coatractoi}`4r:PoweF'of Attortiey(for ttie.ownerj would ba someone with notarized letter from owner authorizing same
<br /> 'OVER'THE COUNTER'.PERMIT-TING�=�.;:•(Frontof iaipplicatio`n Orily): • •:
<br /> Reroofs If shingles Sewers SeivIde"Upgrades A/C _ .Fences',(PIoUSurve /Foote e
<br /> Driveways-Not over Counter if;ompublic roadways.:n®ed§:ROW `
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