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s�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> . � <br /> Data Received �— <br /> ��- � S Phone Contact for Permitting � - �'j- <br /> Owner's Name � ['� C' Owner Phone Number �^ � / <br /> Owner's Address �r � �c � Owner Phone Number <br /> Fee S(mple Titleholder Name Owner Phone Number <br /> Fee Slmple Titleholder Address <br /> JOB ADDRESS � ' �`� LOT# �(� <br /> SUBDNISION ,c ��G �� ( PARCEL ID# "� ^� .- —(> �� � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR e ADD/ALT 0 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 �/ ljv �, <br />� BUILDING SIZE SQ FOOTAGE C� HEIGHT <br /> I �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br />� QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> , ���� <br /> ( 6 <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1 <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br />�, FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br />' BUILDER r- �(�jMP� �� ' <br /> G� S <br /> SIGNATURE �U�� (J�� " � REGISTERED Y/ N FEE CURRE� Y/N <br /> .__ _...._....._. <br /> �,....� <br /> � ^ <br /> Address . �..�. .�/._` � Lr �'J��� License#.. .__ �•��.�c�,�f, -_.._., \, <br /> ._.__._...�..._._..._.._.___........�.........,._„�:.. ..._.,.....�.._. <br /> ELECTRICI • � (.Y,�. ,� � COM /KNY�"... Y.. -� �y� <br /> SIGNATUR� c�\�`�— � �K -°°� °r� �`'�� <br /> �W _.,,,�REGIS RED Y/ N FEE CURRE� __Y_/_N•�--�•"'��� <br /> - �`"----.�_..�_._..____._--._......... -_ <br /> Address License#^ <br />� PLUMBER � COMPANY �� � C� <br />�i SIGNATURE e � �� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � ��. � ��e�, �-��J� License# <br /> MECHANICAL COMPANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> DTHER COMPANY <br /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br />�i �ESIDENTIAL 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,ConsUuction Plans,Stormwater Plans w/Silt Fence instalied, <br /> San(tary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> :OMMERCIAL Attach(3)complete sets of Building 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. Requ(red onsite,Constniction 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 /> 51GN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> )irections: <br /> Ffll out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over a2500,a Notice of Commencement is required. (A/C upgrades over a7500) <br /> ' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> )VER THE COUNTER PERMITTING (Front of Application Only) <br /> 2eroofs if shingles Sewers Service Upgrades A/C Fences(PlodSurvey/Footage) <br /> Driveways-Not over Counter if on pubiic roadways..needs ROW <br /> Cli <br />