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' 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> ' Building Department
<br /> Date Received �'--' � �� -- �O
<br /> �L� � Phone Contact for Permitting
<br /> 1 1 1 1 1 1 I I - 1 r 1 i 7 -
<br /> Owner's Name � (.:�1 C��5 ��. � ,( � Owner Phone Number � �- 1C �
<br /> ,
<br /> Owner's Address �.��� �C.,�Q/ � ��� � � / �4` �� Owner Phone Number �
<br /> Fee Simple Titleholder Name � Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOBADDRESS �Q`\ �`�I� f�ll\S 335`I LOT# ��
<br /> SUBDIVISION PARCEL ID# �� �1 '�� '� - 6 � ��� - � �l,���) `�L�
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED � NEW CONSTR B ADD/ALT � SIGN Q � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q
<br /> DESCRIPTION OF WORK �nsk�.\\c��vr� � C` �� �Q,r{Y1 s S.�.e,r�,-1
<br /> BUILDING SIZE ��K'7"� ��� SQ FOOTAGE � CJ 9� HEIGHT ��
<br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> �ELECTRICAL $ �/ �� �../ AMP SERVICE � PROGRESS ENERGY � W.R.E.0
<br /> �/
<br /> �PLUMBING �� �1�� � ��/ _ �yO��
<br /> - �� �
<br /> �MECHANICAL $ VALUATION OF MECHANICAL INS�TALLATION �irl',' //�r,��i _ �
<br /> l5
<br /> �GAS � ROOFING Q SPECIALTY � OTHER
<br /> ! --�-��
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO �/ '3V �/
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<br /> _�_�_� •
<br /> BUILDER -" COMPA ' (� (�C
<br /> SIGNATURE � REGISTERED Y N FEE CURRE� 'Y!N
<br /> Address � - '"�;:iCJ-C.��C � � C�(
<br /> License#�
<br /> ELECTRICIAN � COMPANY �-.�.�. �/)Q�rj'r lnC �ba A•13.�1'�C�S S�C
<br /> SIGNATURE REGISTERED / N FEE CURRE� Y/N
<br /> Address ��� �-�G2�121� � r+; ��j,,,-�`5 �icense# �F4O�/�SS
<br /> PLUMBER � COMPANY '- -
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# � -�
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address
<br /> License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address
<br /> License#
<br /> 1111111111111111111111111111111111111111111111111111111111111111111
<br /> RESIDENTIAL Attach(2)Plot Plans, (2)sets of Building Plans;(1)set of Energy Forms, R-O-W Permit for new construction,
<br /> Minimurr ter(1C)work�ng days after submittal date. F2equired onsite,Construction Plans,Stormwater Plans w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllarge projects
<br /> COMMERCIAL Attach(3)complete sets of Building 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 Work Permit for all new projects.All commercial requirements must meet compliance
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans.
<br /> **'*PROPERTY SURVEY required for all NEW construction.
<br /> Directions:
<br /> Fill out application completely
<br /> Owner&Contractor sign back of application,notarized
<br /> If over$2500,a Notice of Commencement is required. (A!C upgrades over$7500)
<br /> " Agent(for the contractor or o r f o e omeone with notarized le r f �rcLpuv�e+�u}bprjun4saaie._ ,_ �
<br /> OVER THE COUNTER PER ING ,,;(Fror�t of Application Only) .
<br /> Reroofs if shingles Sewe .�eorice Upgrades A/C Fences( IoUSurvey/Footage) � � "���r�
<br /> , , n•�r. , _•:aN a
<br /> Driveways-Not over Cou er if or�,Pu��c roadways..needs ROW ' ' '' � ��'r �' � "
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