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<br /> 813i 780-0020 City of Zeph�rhills Permit Hpplication � ~ Fax-813-780-0021
<br /> B iilding Department
<br /> Date Received ` '
<br /> ����� Phone Contact for Permitting �� �`,� -- ���
<br /> / �
<br /> Owner's Nam� C� �' � � �,j Owner Phone Number
<br /> � ,,
<br /> Owner's Address � �� � � Owner Phone Number
<br /> Fee Simple Titleholder Name �— � Owner Phone Numbe�
<br /> 9
<br /> Fee Simple Titleholder Address � �
<br /> JOB ADDRESS � /j 11��� ry I LOT# [�
<br /> SUBDIVISION /` wo( �?o/'��04/ � PAR�ELID# -�J �pj - �� �� - �(O 0 � � � 6 O
<br /> WORK PROPOSED NeW CoNSTR ADD�,��LT � SIGNINED FR�OM PROPER1YTAx�NOTicE)DEMOLISH �
<br /> , B INSTALL e REPAIR °
<br /> PROPOSED USE � 0 SFR Q COM� � OTHER
<br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME [� STEEL Q
<br /> DESCRIPTION OF WORK I,�M 0 vC /� � p /Z ,./L,�i�c+(� r,j �l /jy
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<br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT
<br /> �BUILDING $ � o / VALUATI�N OF TOTAL CONSTRUCTION �,����
<br /> �
<br /> DELECTRICAL $ � AMP SER�ICE � PROGRESS ENERGY � W.R.E.C.
<br /> �PLUMBING $ 1• ��C /f
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<br /> OMECHANICAL $ VALUATI �N OF MECHANICAL INSTALLATION �����'v� v'
<br /> GAS i �'�/�
<br /> 0 Q ROOFING Q SPECIALTY 0 OTHER �
<br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO
<br /> BUILDER � , � ,� �OMPANY ��`�c�ot�/ �ai/ a� � � �
<br /> SIGNATURE ,�� , REGISTERED Y N FEE CURRE�, /N
<br /> Address � 0 ���c�fjn��;� � - � � , License# ��G �,��/�l9
<br /> ELECTRICIAN IOMPANY '
<br /> SIGNATURE `'; ' REGISTERED Y/ N FEE CURRE� Y/N
<br /> Address ' ' ' ' ' ' �' ' License#
<br /> PLUMBER � � � � �OMPANY
<br /> SIGNATURE � � � REGISTERED' ' ' Y/ N FEE CURRE� Y/N
<br /> , �
<br /> � �,��� ,� , , , , , �
<br /> Address � License#
<br /> MECHANICAL IOMPANY
<br /> SIGNATURE EGISTERED Y/ N FEE CURRE� Y/N
<br /> ;
<br /> Address � License#
<br /> OTHER ; �OMPANY
<br /> SIGNATURE �I REGISTERED Y/ N FEE CURRE� Y/N
<br /> A
<br /> Address !��; License#
<br /> ,9�., ,i
<br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction,
<br /> Minirhum ten(10)working days after submittal date. �Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed,
<br /> Sani,tary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects
<br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a LifeySafety Page;(1)set of Energy Forms.R-O-W Permit for new construction.
<br /> Miniinum ten(9Cj working days after submittal date. '�Ftequired onsite,Construction Plans,Stormwater Plans w/Silt Fe�ce installed,
<br /> 5anitary Facilities&1 dumpster.Site Work Permit fo�all new pro;ects.All commercial requireme_nts must meet comptiance
<br /> SIGN PERMIT Attach(2)_sets of Engineered Plans. -"�----
<br /> _ - -----_ - �*'°*PRGPERTY SURVEY�requirc:d fcr aii i�EVV cor�stl uciion. -- - -- - _ � - --- - - =-
<br /> Directions: �. ,i
<br /> Fill out application completely. � i�
<br /> Owner&Contractor sign back of application,notarized � ---
<br /> If over$2500,a Notice of Commencement is required. (A/C up'grades over$7500)
<br /> *' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same
<br /> OVER THE COUNTER PERMITTING (Front of Application Only) �� ,
<br /> Reroofs if shingies Sewers Service Upgrades A/C Fenc N s(Plot/Survey/Footage)
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<br /> Driveways-Not ove�.Counter if on public roadways,.needs ROW I'� , '
<br /> ;�'� . � � � �; . � . , � - , , . , � . � �
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