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` �- J <br /> 1 <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> : Building Department <br /> Date Received �—�3' �� I �/j �(�7.•�_5�c� <br /> Phone Contact for Pecmitting <br /> Owner's Name H ven-fi s-� Hec�/�-h S s�n! Owner Phone Number <br /> Owner's Address 7O.7v �I �i�'a' • � ` I Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> I <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS ��`� `1-�`-�-� J�-�-/ '-Z I �� ���l � LOT# � <br /> SUBDIVISION PARCEL ID# �5-�Jr' ��"����` `7��'� �C`.� <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL e REPAIR � <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTIONOFWORK ��STOJ�� C7LBp7/�/, �/2°�, � � � � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE ' Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ' <br /> � C� o� - 1�-�— <br /> �MECHANICAL / ��e �p VALUATION OF MECHANICAL INSTALLATION � �P <br /> � � � ' � 2� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER �� <br /> FINISHED FLOOR ELEVATIO S FLOOD ZONE AREA QYES NO � <br /> BUILDER l�r 1, COMP I Y C/�?TC� �I�/'�� ` ' v�V' <br /> SIGNATURE `��� REGISTERED Y/ N FEE CURRE� Y/N <br /> i <br /> Address I License# <br /> i <br /> I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURREA Y/N <br /> i <br /> Address I License# <br /> I <br /> PLUMBER COMPANY <br /> � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address I License# <br /> I � � <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address � License# <br /> OTHER COMP I Y <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address I License# <br /> 111111111111111111111111111111111111111111111111111111111111111�1111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new consUvction, <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 Permit for subdivisions/large 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 commeraal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ****PROPERTY SURVEY required for all NEW construction. <br /> . . . . . . ._.__. . . . .�. . . <br /> Directions: , � <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br />� If over 52500,a Notice of Commencement is required. (AIC upgrades over 37500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be solmeone 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(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> � <br /> i <br /> i <br /> � <br />