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sis-�so-oo2o City of Zephyrhills Permit Application F�-813-780-0021
<br /> Building Department
<br /> ,
<br /> Date Received -- 1 d�
<br /> Phone Contact for Perm itting �� v •,,�.� ` .«�s� ��
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<br /> Owner's Name Owner Phone Number �� � " �I[ �
<br /> Owner's Address Y�- Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS LOT# �
<br /> SUBDIVISION PARCELID# �� � "� ,� 1
<br /> ,��_,_,,....,���``` (OBTAINED FROM PROPERN TAX NOTICE)
<br /> WORK PROPOSED e NEW CONSTR � ADDlALT � SIGN � MOVE � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE � SFR � COMM � OTHER
<br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � OTHER
<br /> DESCRIPTION OF WORK �
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT n 1}�f�/��
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<br /> 'iN�tii �
<br /> � � %
<br /> BUILDING $ v� VALUATION OF TOTAL CONSTRUCTION
<br /> � ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R E C.
<br /> 0 PLUMBING 8 /�
<br /> � MECHANICAL $ VALUATION OF MECHANICAL INSTA L TION � � V
<br /> GAS ROOFING � SPECIALTY � OTHER ���� Q/\�
<br /> 0 0 � - � p�
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES �NO ��
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<br /> BUILDER // —i ��. �COMPANY I �— ,C�tij
<br /> SIGNATURE � � REGISTERED Y/ N FEECURRENT Y/N
<br /> Address 6( _ � License# LQ(„jJ��p 2}g�
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License#
<br /> PLUMBER COMPANY
<br /> SIGNATURE REGISTERED Y! N FEECURRENT Y/N
<br /> Add ress Ucense#
<br /> MECHANICAL COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address License#
<br /> OTHER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Atltlress 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. Required onsite,Construdion Plans,Sanitary Facilities&1 dumpster
<br /> COMMERCIAL Attach(3)sets of Buildmg Plans;(1)set of Energy Forms.
<br /> Minimum ten(10)vrorking days after submittal date. Required onsite,Construction Plans,Sanitary Facilities&1 dumpster
<br /> All commercial requirements must meet compliance.
<br /> SIGN PERMIT Attach(2)sets of Engineered Plans
<br /> •"'PROPERTY SURVEY required for all NEW construction.
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<br /> �Directions:
<br /> Fill out application completely
<br /> Owner&Gontrador sign back of appliption,notarized
<br /> If over E2500,a Notice of Com mencement is required. (AIC upgrades over 55000�
<br /> •' Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notar¢ed letter from ovmer author¢ing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only)
<br /> Reroofs Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage)
<br /> Drrveways-Not over Counter rf on public roadways.needs ROW
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