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813-78D-ti020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> � Building Department <br /> Date Received � � � � _ 3 � <br /> � Phone�Contact for Permittin <br /> Owner's Name 0� V�� Glo�.� Owner Phone Number 0 � Sb� �`��D <br /> Owner's Address �'�a . �1C�a D ccil— Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��I a2 S�� u+i— LOT# � <br /> SUBDIVISION SS �2.va �r�10.2 PARCEL ID# U ' � - 2�' �O�oO� �D �- UO 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED , B NEw CONSTR ADD/ALT Q 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 `TV► I d� �� � p�- � t'I '��p ' p�� co��1 (�vl� S'' �,J !�, <br /> t <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY � W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY �� �wf�e,�- <br /> SIGNATURE ' (w � REGISTERED N FEE CURRE� Y/N <br /> Address �l0` S, �G11(e�oz � . Ltcense# �� 2 � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE -' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# <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 <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' Ucense# <br /> RESIDENTIAL Attach(2)Plof Plans;(2)sets-of.Building Plans;(1)set of Energy�Fortns;R-O-W Pertnit far new construction, <br /> Minimum ten(10)working days after submittal date. Requlred onsite,Construc6on P1ans,Stom►water Plans w/Silt Fence installed, <br /> San(tary FacillUes 81,dumpster,.Site Wortc•Rertnit for su6divislonsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Buildirig'Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new consUuction. <br /> Minlmum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary FaciliUes&1 dumpster.Site Work Pertnit for ail new projects.All commercial requlrements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans:, <br /> ""PROPERTY SURVEY required for all NEW construcUon. . <br /> Directlons: <br /> Ffll out applicallon completely. <br /> Owner 8 Contractor sign back of appl(caUon,notarized <br /> If over 52500,a Notice of Commencement t�requtred. (AlC upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER.PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drivewaya-Not over Counter(f on public roadways..needs ROW <br />