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� ,�����eo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � ' Building Department <br /> Date Received �� i Phone Contact for Permitting - <br /> Owner's Name � '� Owner Phone Number S � � <br /> Fe�ner's Address [ � /Ol �' Owner Phone Number <br /> mpSle`fitle��de�Na o �Owner Phone Number <br /> Fee Slmple Titleholder Address .J 7 � �.�1 , J '� � - � � � � ��r <br /> JOB ADDRESS � � � LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK n 6 C t��� n <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ ����y VALUATION OF TOTAL CONSTRUCTION <br /> � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � 'b2�q <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS . Q ROOFING Q SPECIALTY Q OTHER <br /> FIfVISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY , ��'G�lti��� <br /> SIGNATURE REGISTERED Y N FEE CURRE� Y/N <br /> Address License# <br /> ELECTRICIAN COM PANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# <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 License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N -_ <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConsVuction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br /> SIGM 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 applfcaUon,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />