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e�saao-oo2o City of Zephyrhills Permit Application Fax 813-780-0021 <br /> j . . Buflding Departrnent <br /> Date Received Phone Contact for Permtttin <br /> j� 2 - � �� ,� <br /> - cy t ic o�v <br /> Owner's Name / ' Owner Phone Number'-_. . ..-. g'l — / ' 8 <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address ' <br /> JOB ADDRESS `�� O `Q�j.s6/Y) L l� , D�aN e 1DS� �qNG LOT# � <br /> sueoiwsioN PARCEL ID# J5-��-' l- !"7� b��Od UDfal� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED , e °NEW CONSTR� ADD/ALT [� SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED:USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK ' Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK ' �GS, �/C C1�`/g/�V �'U� � � �/�JeN�S � ��, <br /> BUILDING SIZE � SQ FOOTAGE HEIGHT <br /> QBUILDING $ VALUATION'OF TO`fAL CONSTRIJCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ �h LJ'� b� VALUATION OF MECHANICAL INSTALLATION <br /> oc'T <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRER Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE y REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL ` " COMPANY �H2 S �/�.� ���.=/ /r <br /> SIGNATURE ��J�G REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ����'/I�G�Iv �/LL , f `. License# �`���7�'.j /�� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAI: Attach(2)Rlot Plans;(2)sets of Building'Plans;(1)set of Energy Fortns;R-0=W Permit for new construction, <br /> Minimum,ten,(1,0)�working daysaftec submittai date. Requlred onsite,ConsUuction Plans;Stormwater Plans w/Stlt Fence installed, <br /> Sanitary Facilities&�•1_dumpster,Site Work Permit for subdivisions/large projects � <br /> COMMERCIAL Attach(3)coinplete setis of BuitcJirig Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcdon: <br /> Minimum ten(10)worktng days'after submittal date. Requ(red onsite,ConsUucUon Plans,Stortnwater Plans w/Silt Fence installed, --- _ <br /> Sanitary Facilitles&1 dumpster.Site Work Pertnit for all new proJecis.All commercial requlrements must meet compliance - � <br /> SIGN PERMIT Attacli(2)sets of Eiigtneered Plens._. -� <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out applicatlon completely. <br /> Owner 8 ConVactor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement i�required. (AlC upgrade�over E7500) <br /> " �qent(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(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />