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<br /> 813-780-0020 • City of Zephyrhills Permit Application Fax-813-780-0021
<br /> � ' Building Department
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<br /> ceived Contactfoi'Permitting –
<br /> Date Re ��,, , , ,,,,, ,,,,, � ., -.�,,,..,-,., ,,, ,..., w, .. v, . „Phone ,. „��, ,,,,,,�,. ,, ... - - -
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<br /> Owner's Name . Owner Phone Number V �'fV `- /�
<br /> Owner's Address � pC � Owner Phone Number
<br /> Fee Simple Titleholder Name Owner Phone Number
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<br /> Fee Simple Titleholder Address-
<br /> JOB ADDRESS � /� LOT# �
<br /> SUBDIVISION 1`� / " � l PARCEL ID# �1 � ��O C/�O 1 �
<br /> (OBTAINED FROM PROPERTY TAX NOTICE)
<br /> WORK PROPOSED �NEW CONSTR e ADDlALT Q SIGN Q MOVE � DEMOLISH
<br /> INSTALL REPAIR
<br /> PROPOSED USE Q SFR � COMM Q OTHER
<br /> ' TYPE OF CONSTRUCTION �BLOCK � FRAME Q STEEL Q OTHER
<br /> DESCRIPTION OF WORK � ��+�1 l%/� �� ��-✓"� 1 1 � Y GO� ���l/� W W �
<br /> BUILDING SIZE SQ FOOTAGE HEIGHT
<br /> Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION
<br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C.
<br /> Q PLUMBING $ - �`C�
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<br /> � MECHANICAL $ � � VALUATIO OF MECHANICAL INSTALLATION ���
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<br /> Q GAS Q ROOFING � SPECI�4LTY � OTHER
<br /> FINISHED FLOOR ELEVATIONS FLbOD ZONE AREA QYES QNO
<br /> BUILDER COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address I License#
<br /> ELECTRICIAN COMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y!N
<br /> Address I License#
<br /> PLUMBER COMPANY �
<br /> SIGNATURE _ � REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address I License#
<br /> MECHANICAL � r ! COMPANY � r �
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/,N
<br /> Address d� C �r[�- 1UY � I� License# �
<br /> OTHER C�OMPANY
<br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N
<br /> Address I License#
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms
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<br /> —"Niirnmum ten(10)worfcing day`s after subrriiftal date.-Required onsde,Construction PI'ans,Sanitary Facilities&1 dumpster
<br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Forms. I '
<br /> Minimum ten(10)working 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 /> I Directions: � �'��R ���
<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$5000)
<br /> �' Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only) '
<br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage)
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<br /> Driveways-Not over Counter if on public roadways..needs ROW
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