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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recei�ed' ' C �� _ � � L� <br /> Phone Contact for Permitting <br /> Owner's Name �R�I�/Q.� ���Jc.°�2 Owner Phone Number O��� ��J� �p��3 <br /> Owner's Address � `.�� �P�jB S,y/�� �� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��T �eIQ/$ S�l�,'� ��Q� �'-�/GLS �3j���, LOT# � <br /> SUBDIVISION l/V�� L-°�C� PARCEL ID# I� �� �l D��G/ �� �i�� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR�ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �emo ve � �e `�� �• � T/� � �G� /��- GC/y) <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br />� Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ �'I' � <br /> QMECHANICAL $ �/��5-� � VALUATION OF MECHANICAL INSTALLATION <br /> � f `' <br /> T <br /> OGAS Q ROOFING Q SPECIALTY 0 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 A�1Q S 6/�D �2CSfy'S �%C�° � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N I <br /> Address � � /��1� • � �/��j License# C��}� �.���-� <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 construcGon, <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 /> COAIiMERCIAL 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 /> Directions: I <br /> Fili out application completely. ; , � <br /> Owner 8�Contractor sign back of application,notari�ed j <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 /> 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�oadways..needs ROW'�:F , �i <br /> , , , <br />