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<br /> ' 313-780-0020 City ofZephyrhills PermitApplication Fax-813-780-0021
<br /> Building Department
<br /> Date Received + .� , r � �
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<br /> Owner's Name � ( Owner Phone Number
<br /> Owner's Address `� Owner Phone Number
<br /> Fee S�mple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS � �T LOT # �- 9
<br /> SUBDIVISION PARCELID# "'pr�p'� I • ���'���
<br /> (OBTAINED FROM PROPERTY TA% NOTICE)
<br /> WORK PROPOSED e NEW CONSTR � ADD/ALT � SIGN � MOVE � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK � FRAME � STEEL � OTHER
<br /> DESCRIPTION OF WORK ,KyC � , �
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
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<br /> � �R�./ BUILDING $ ^ �
<br /> T � VALUATION OF TOTAL CONSTRUCTION
<br /> � ELEGTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R E.C.
<br /> � PLUMBING $ � � /�
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<br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION
<br /> � GAS Q ROOFING Q SPECIALTY Q OTHER
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO
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<br /> BUILDER � � COMPANY �� �
<br /> SIGNATURE REGISTERED Y/ N , FEE CURRENT Y! N
<br /> Address � �' License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y! N
<br /> Add ress License #
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y/N
<br /> Add ress License #
<br /> MECHANICAL � COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y/N
<br /> Add ress License #
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEECURRENT Y1N
<br /> Address License# �-
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<br /> RESIDENTIAL Attach (2) Plot Plans, (2) sets of Building Plans, (1) set of Energy Forms
<br /> Minimum ten (10) working days after submittal date. Reqwred onsite, Gonstrudion Plans, Sandary Faalities & 1 dumpster
<br /> COMMERCIAL Attach (3) sets of Building Plans, (1) set of Energy Forms.
<br /> Minimum ten ('10) �,wrking days after submittal date. Reqwred onsite, Construdion Plans, Sanitary Facilities & 1 dumpster
<br /> AII commercial requirements must meet compliance
<br /> SIGN PERMIT Attach (2) sets of Engineered Plans.
<br /> "'•PROPERTY SURVEY required for all NEW construdion.
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<br /> Directi on s: "'�"" " "'
<br /> Fill out application completely
<br /> Owner & Contractor sign back of application, notanzed
<br /> If over $2500, a Notice of Commencement is required. (AIC upgrades over 55000)
<br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notar¢ed letter from owner author¢ing same
<br /> OVER THE COUNTER PERMITTING (Front of Applicahon Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences (PIoVSurvey/Footage)
<br /> Dnveways-Not over Counter if on public roadways .needs ROW
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