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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> C Building Department
<br /> Date Received Phone Contact for Permitting —
<br /> Owner's Name �� �l h� ` Owner Phone Number
<br /> Owner's Address I � , S � J Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS 5rj o LOT#
<br /> SUBDIVISION PARCEL ID#
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED R
<br /> NEW CONSTR R ADD/ALT = SIGN = = DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE = SFR 0 COMM = OTHER
<br /> TYPE OF CONSTRUCTION Ql BLOCK Q FRAME = STEEL =
<br /> DESCRIPTION OF WORK
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY Q W.R.E.C.
<br /> =PLUMBING $
<br /> 03i'MECHANICAL VALUATION OF MECHANICAL INSTALLATION
<br /> =GAS = ROOFING Q SPECIALTY = OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
<br /> Address License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREN LZIN
<br /> Address License#
<br /> PLUMBER COMPANY
<br /> 'SIGNATURE REGISTERED Y/ N FEE CURREN
<br /> Address I License#
<br /> MECHANICAL COMPANY I ra tog 19 pmto
<br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
<br /> Address �� � ICU Z e h &h,-(4 (- 33f3g License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N
<br /> Address License#
<br /> RESIDENTIAL Attach(2)PlotPlans;(2)sets of Building..F--tans;(1)set of Energy:Forrns;.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,W,o�k'.Permit for subdivisions/large pr`ojects'.
<br /> COMMERCIAL Attach(2)complete.sets,of Building-P-Ians,plus a L`ife Safety Page;:;(1)set oflEnergy Forms:.R-O-W Permit for:hew,construction,
<br /> Minimum;ten(10)workingldays aftersubmlttal',date:, Reguiied.'onsite,Consfruction Plans,,Stomtwater•,Plans,w/:5iit Fence'installed,:
<br /> Sanitary,Facilities:&'1'du'mpste.r:.Site,-.Wo'rk,Permit;for;all'new:projects:All,commercial'kequirements must:meet`compliance
<br /> SIGN PERMIT Attach(2)sets:of•Engineered'Plans x
<br /> '""'PROPERTY:SURVEY.,required,for,,rall',NEW-construction,,, ,
<br /> 'D)rectlons:
<br /> Fill out application completely;-
<br /> Owner&Contractor si 9..naiack'of,a 'lication'notarised
<br /> ;pP,
<br /> If over$2500;.a Notice,'of Cornmencerrlentlis.require'd.'(iA/C.upgrades over$7500),-,. _
<br /> " Agent(for the contractor).or=.Power,of Attomey.,(for_the,,owner),would'b'e.;som'done-witti.notarised;letter from,owner authorising;same_
<br /> OVER THE COUNTER PERMITTING;:;`.:',,',,(copy of comtract4eguired)
<br /> Reroofs if shingles Sewers ;ServIde,Upgrades A/C Fences(Plot/Survey/,Footage) ` : F,; , ,
<br /> Driveways-Not ^:ys over a Counter if on; ublic+roaduva`s:.neetls BROW'`:.:'
<br /> 1,
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