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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department ' <br /> e <br /> Date Received �1 / <br /> '7^( 2'—� - - Phone�Contact�for Permittin :_ ' ��3 , � I'� p 7`� <br />' Owner's Name cJqM-�'�J v � � Owner Phone Number <br /> Owner's Address - Owner Phone Number <br /> Fee Simple Tltleholder Name � - Owner Phone Number <br /> ,�, . . <br /> Fee Simple Titleholder Address "� <br /> JOB ADDRESS � / � % � �`�� �"'1O^� � �-- � <br /> LOT# <br /> SUBDIVISION �� �'E ��^� PARCEL ID# � ' � <br /> � (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED �NeW cONSTR° ADD/ALT Q` SIGN• Q Q DEMOLISH <br /> INSTALL B : 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 '�e �'� r"��� �� r�o►1.�- I • <br /> BUILDING SIZE • SQ FOOTAGE��, HEIGHT.. <br /> QBUILDING $_ -VALUAl'ION O�F�70TAL CONSTRUCTION <br /> ECTRICAL $ 6 0 o AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> . -� l � z�� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS � Q ROOFING Q SPECIALTY-Q, � 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 /> ELECTWCIAN. 'J�- '��°� ,, COMPANY J�"" rS ����1"'ti- L �S�d-i._ i .� c <br /> SIGNATURE REGISTERED Y/ N �e cu�en �Y/N <br /> Addre$� f g��02' �bS�-�,.��c1C l�' ` � �G 336tf� ' " <br /> � � Ucense#; ��� �- r3 � �5 Y`� <br /> PLUMBER , , ,COMPANY. - - <br /> SIGNATURE '' ' � ` _�cis.r�REo Y I,N FEe.Cuw�� Y/N <br /> Address License# � <br /> MECHANICAL , COMPANY � <br /> SIGNATURE ' � X REGISTERED _. Y./-.N FEE CURRE� ,Y/,N-, <br /> Address'' ' � � _ .Ucense# <br /> OTHER " ' � COMPANY � <br /> SIGNATURE � �� " ' • � - ��REGIS7ERED Y/ N.. FEE.CURRE� Y/N <br /> Address , " 4, =, _ �,'± -• „ ' Gicense# <br /> RESIDENTIAL`, ;;_Attach(2)iP:,lot:Plans;.(2):sets�of�8uildtng"Plens;°(•ljsetofEriergy•Forms;�R';O-W`PermiffornewconstiucUon, � <br /> Mlnlmumsten=(1.0)�working�days;after_sutiinittal:dater Requlred onslte,�Constiuctlon Plans;Stomiwater Plans w/Sflt'Fence Installed, <br /> ._ .-. ,.,� .r . . <br /> Sanitary Facilldes:&:7:idumpsterSlte-Work;Pertnit for-subd(v(slons/large;proJects ':` �� y ` .- ; <br /> COMMERCIAL Attach(3)complefe sets`of Bullding Plans plus a Llfe Safety Page;(1)set of Energy Fortns.R-O-W Permit for new constructlon. <br /> Minimum ten(10)working days after submlttal date. Requlred onslte,Constructlon Plans,Stortnwater Plans w/Sllt Fence Installed, <br /> SeNtary Facllides&1 dumpster..Slte Work Pertnlf for all new project"s:All commerclal requlrements must meet compllance <br /> SIGN PERMIT Attach"(2)°sets of En'glneered�Plans.i,.�.��-�^r,���.- .� �� - � - � <br /> "'"•PROPERTY SURVEY reyuired,for all NEW constructlon. - _ _ <br /> Dlrectlons: •� � � _ <br /> FIII out applicaUon completely. <br /> Owner 8 Contractar slgn badc of applicadon,notaAzed <br /> If over 52500,a Notice•,of Commencement Is requlred. (AIC upgrades over 57500) <br /> \� ���rai'�";,i- � . .., . . " <br /> /�qent(for the coritractoc)orPower of Attomey(fo�tFie owne�j would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER.PERMI'1'iING---• -(Front of.�AppllcaUon•Only)�• <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drlvewaya-Not over Counter lf on publlc roadways..neeii§ROW <br />