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a�aaao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> � <br /> Date Received phone Contact for Permitting — <br /> Owner's Name � �y�l ,S� =�..� Owner Phone Number <br /> Owner's Address 3�. /C/�/��A/�� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � ��vI C'�/1�JY1s�/.� LOT# � <br /> SUBDIVISION �L�/1�I �.C/a'�-/�-G PARCEL ID# � S eZS"� — OES'D - D�dOl7--fJY��I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK `�Q�� WG% 3 4 /L �IG��Gfj:S'S ,r,fl/�/!—L� �/f,��� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> �1/4�. <br /> � <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ O,�'� <br /> `b <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �, <br /> QGAS �/ ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <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 /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I <br /> Address License# <br /> OTHER _ J, COMPANY Gt-/9"!�/�✓ �Qy�r/i�G <br /> SIGNATURE � �1 REGISTERED Y/ N FEE CURRE� Y/N <br /> Address JJI�x 3� License# ,�cooy�,� <br /> RESIDENTIAL Attach(2)Piot 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 subdivisionsAarge projects - � -- - <br /> COMMERCIAL Attach(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 /> Dlrections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized � , ' <br /> If over a2500,a Notice of Commencement is requir,ed. (A/C upgrades over$7500) � , <br /> " Agent(for the contractor)or Power of Attomey'(for the owner)�woulii''be`someone with notarized letter from owner authoriiirig same �- � - <br /> OVER 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 RO,W.,; ' ` ,, � , <br />