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. -� \ � ',r' i <br /> �a <br /> � <br /> / ` .. , . , _ (�'� <br /> a�saao-oc�zo City of Zephyrhills Permit Application Fax-813-780-0021 ' �� <br /> , Building Department <br /> Date Recalved Phone Contact for Permittin — <br /> ' . . - /3 <br /> Owner's Name � , Owner Phone Number <br /> I <br /> Owner's Address F 2) l � Owner Phone Number <br /> Fee Slmple Titleholder Name I Oaune�Phone Number <br /> , I <br /> Fee Simple Titleholder Address i�►/ i <br /> JOB ADDRESS ��� c {` W`1�.'. (� L LOT# � <br /> SUBDIVISION PARCEL ID# � Z C�' Z I - <�oI c �- 1 3�G ", Q z� <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM I Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME` Q STEEL Q <br /> DE3CRIPTION OF WORK � �fJ � jf� i U �� <br /> BUILDING SIZE �-- r / k �U� 00 GE �7,�� HEIGHT U r d�� <br /> i <br /> QBUILDING $ dU ALUATIONI OF TOTAL CONSTRUCTION <br /> ��d ._ <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � ,�•`b`��� <br /> I �Al Q ,L S�'�S <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � C pW�� �,IG A/ <br /> A �f.. <br /> Q GAS - l�� 'J " <br /> Q ROOFING Q SPECIALTY Q OTHER , 5 �J�7' <br /> FINISHED FLOOR ELEVATIONS L <br /> FLOD i ZO - QYES NO <br /> ., <br /> � <br /> BUILDER ' <br /> �C I N� ' <br /> SIGNATURE � TERED Y/ N FEE CURRE� Y/N <br /> Address ��`� � 7 License# '' ' I <br /> L �� <br /> ELECTRICIAN ��( �P Y S� <br /> SIGNATURE RE�isT�p� Y/ N FEE CURRE� Y!N <br /> Address ; License# - �'" <br /> PLUMBER C IMPANY <br /> 'SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL - COMPAtdY I <br /> SIGNATURE ;�.J REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ( License# <br /> " i <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA 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 far new construcUon, <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 Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Sefety Page;(1)set of Energy Forms.R-O-W Permit for new consUuction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,-Stormwater Plans w!Silt Fence installed, <br /> ` Sanitary Facilities&1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compllance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. � <br /> ""PROPERTY Sl1RVEY required for all NEW construction. <br /> Directions: - <br /> Fill out applicaBon completely. �, ' <br /> Owner&Contractor sign back of appi(cation,notarized�� , , '� � <br /> If over a2500,a Notice of Commencement is required. (A/C upgrades over;7500) .._ --... _ ,; �••; <br /> �� �• -- <br /> " Agent(for the conVactor)or Power of Attomey(for the owner)would tie someone with notarized letter from owne�-autliorizing same � _ ' �� <br /> OVER THE COUNTER PERMITTING (Front of Application Only) i � � � , �� � � � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences,(PIoUSurvey/Footage) , _ � � . ` „ � <br /> Driveways-Not over Counter if on public roadway's..needs ROW ,,��} :, ; � ' ° " .=. - :� _ , <br /> , ' . , � t' <br /> . _ ., , <br />