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� �_ 813-?80-0020 City of Zephyrhills Permit Application Fax-813-780-0021
<br /> 8uiiding Department
<br /> ��
<br /> I�^�°�'�''"'-,'`<i,-,a`
<br /> Date Received phone Contact for Permitfing
<br /> Qwner's Name � �, Owner Phone Number s�s' �1 rY�-'�
<br /> Owner's Address �5. .•� , -�' ��n Owner Phane Number � �
<br /> Fee Simpl�Titleholder Name Owner Phone Number �' �
<br /> t � {'.
<br /> I M y,• Y
<br /> Fee Simple Titleholder Address
<br /> JOB ADDRESS Ce " /I ,s" � �3 LOT# ��
<br />(- = - -- - __. _ J s
<br /> SUBDIVIStON j7C%/►rc � '- -- - --6'A,ftC�trlD# � �° �i°� ,
<br /> (OBTAINED FROM PROPERTYTAX NOTIGE) .
<br /> WORK PROPt7SED e NEW COtVSTR� ADD/A�T � SIGN Q Q DEMOLtSH
<br /> - INSTALL REPAIR
<br /> PROPO:'��D USE i� �/5FR Q COMM C� OTHER
<br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q
<br /> DESCRIPTIOId OF WORK �°" .� _ • c�,r
<br /> BUtLDtNG StZE � � SQ F007AGE �� HEIGHT C �
<br /> UIl.DING $�G � VALUATION OF TQTAL CONSTRUCTION
<br /> QE�ECTf2lGA� � � AMP SERVICE �, PFtOGRESS ENERGY Q IN.R.E.C.
<br /> QPWMBING � �
<br /> ,......,,_,,,....., �,�t� CJ
<br /> QMECHANICAL $ VALUATION pF MECNANICAL INS7ALlAT10N ',�. � �
<br /> ��
<br /> QGAS Q F200FENG Q SPECIALTY C� OTHER
<br /> FINISHED FLOOR ELEVATIONS �---�� FLO��OD ZONE AREA QYES NO
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<br /> BtittOER � � COMPANY ��" C:��.
<br /> SIGNATURE REGISTERED Y/ FEE CURRE� Y/N
<br /> Address Csf'�% � ` License# ��'?�.C-L�f��
<br /> EL�CTRICIAN ✓�/�,�,� ` � 1 COMPANY
<br /> SIGNATURE � / REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> PWMIBER �"'� A, COMPANY
<br /> SIGNATURE �~ i ' REGISTEREp Y/ N FEE CURRE� Y/N
<br /> Address License# � I
<br /> MECHANICAI. COMPANY
<br /> SIGNA7URE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> , ,,.._
<br /> OTHEF2 COMPANY
<br /> SIGfdATURE REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address License# �— �
<br /> �t�S1t}EiVTlAL Attach{2)Ptot PEans;{2}sets of Building Plans;{1)set of Energy Forms;R-4-W Permif far new canstrucfion,
<br /> Minimum ten(10)working days after submittal date. Required onsite,Construckion Plans,Stormwater Pians w/Silt Fence installed,
<br /> Sanitary Facilities&1 dumpster,Site Work Permlt-for subdivisions!large projects �
<br /> COMMERClAL Attach(3}compie#e sets af Buitding Ptans ptus a Life Safety Page;(1}set of Energy Farms.R-O-W Pecmit for new eanstructian.
<br /> Minimum te�(10)working days after submittal date. Required onsite,Construction Plans,Starmwater Plans w/Silt Fence installed,
<br /> Sanitary Facit�ties 8�1 ifumpster.Site Work PermJt for a1C new pro�ects.All commerciai requirem�nts must meet compliance ,
<br /> StGN PERNi1T Attach(2}sets of Engineered Plans.
<br /> .«.«PROPERTY SURVEY required for all NEW cansWCtfon.
<br /> Directions:
<br /> Fill out application completely.s•.:�.•. =-- -- � x..-•--- . •� --- :, _ , �
<br /> 4wner&ConUactor sign back'of application;notar€zed :: : .�...-.:...;-»_=r=_>_.___..,-.:» ., ,
<br /> �, If over 52500,a Notice of Commenceinent is required:' (A/C upgcades over 57500) ° ' � ` � ,
<br /> y� :, ,;:r ;- � ; ,��`
<br /> "' Agent{for the contractor}or Power of tittomey.(far the,owner)woulii be someone with notarized letterufrom owner authorizing�same'
<br /> OVER THE COUNTER PERMITTING�'�' ��"(Front ot'Application Only)�}��'£��} „ w,_ ... . --.. . ��- -- --. -� °- '- "' .,
<br /> � Reroofs if shingles Sewers Service Upgrades A/C Fences(PIot/Survey/Footage)
<br /> Driveways-Not over Counter if on public roadways..needs ROW
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