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s�saso-oozo , Cit�of Zephyrhills Permit Application Fax-813-780-0021 <br /> �, • Building Department <br /> Date Received Phone Contact for Permitting — <br /> Owner's Name �'����� M�'�� �� �- �,L1►J��- Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number ' <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �� S�D 1 U M Q.��I'F LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINEO FROM PROPER AX NO ) <br /> WORK PROPOSED B NSTALLSTR e REPAIR � SIGN Q DEMOLISH <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �I+R O 1 N T F,f2,l o1L � M 1 S C. • '� f.IZI O R. <br /> BUILDIMG S E SQ FOOTAGE� HEIGHT <br /> BUILDING $�� 0O� d�, VALUATIONOFTOTALCONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER /� COMPANY w� LL� � �`��C c'�IT�S . LL <br /> SIGNATURE f— �� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 'Sy3S M� �. ����1�. ST- .S 1� �Tf - License# �G �'�O <br /> ELECTRICIAN COMPANY <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 /> M ECHANICAL COM PANY <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,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL AYach(3)complete sets of Building Plans plus a Life Safety Page;(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,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades 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 /> i <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />