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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Data Rece4"�ed �— C�—�� :Phone Contact for Permittin — <br /> Owner's Name 1'l� �I��s Owner Phone Number � ��' �� <br /> Owner's Address � � v�3 Owner Phone Number � <br /> � <br /> Fee Simple Titleholder Name J 3 � Owner Phone Number <br /> Fee Simple Titleholder Address ` <br /> JOB ADDRESS � !�� � ��' LOT# � <br /> SUBDIVISION � 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 /> �, � ^. <br /> DESCRIPTION OF WORK �l �— C�� / �`� � <br /> BUILDIPIG SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION _ <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> ,�ECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �C�o ���7�� . <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � / Q � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N ' <br /> Address Llcense# I <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N -FEE CURRE� Y/N <br /> Address � License# <br /> PLUMBER COMPANY <br /> SIGNATURE Re�is�RED Y/ N FEE CURREA Y/N <br /> Address License# <br /> MECHANICAL - COMPANY TCC� �,�U(C� 6T� P�C� <br /> SIGNATURE REGISTERED Y�/ N FEE CURRE� Y/N <br /> Address License# ����S _!O <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addre$s � - • License# <br /> RESiDENTIAL, .Attach(2)Plot�Plans;.(2)sets�of:Building'Plans;(1)set of-Energy�Form's;R-O-W Pemiit for new constructi,on, <br /> Minimum:ten(1,0)•working:days.after,submittal date: Required onstte,Construction Plans;Stortnwater Plans w/Silt Fence installed, <br /> � SanitaryFaciltUes;&,1,dumpster3ite'Work•Pertnitforsub'div,islonspargepro)ects � <br /> COMMERCIAL Attach(3)complete`sefs�of Building Plan's plus a Life$afety Page;(1)set of Energy Forms.R-O-W Pertnit for new construcUon. ` <br /> Minimum ten(10)working days aRer§ubmittal date. Required onsite,ConsUucUon Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Permit for ail new projects:All commercial requirements must meet compliance <br /> SIGN PERMIT Attach"(2)sets of'Englneered Planss�. ��^ <br /> •'••PROPERTY SURVEY reguired_for all NEW consttuction. - <br /> Directions: ' <br /> FIII out applicaUon completely. <br /> Owner&Contractor stgn back of-applfcaUon,•notarized_ ._ _ . <br /> ff over 52500,a Notice of Commencement,is.requlred.,, (AlC�upgrades over 57500) <br /> t�„ <br /> " Agent(for the contractor)or Power of`Attomey(fo��the'owner)would be someone with notarized letter from owner authorizing same <br /> - i� � i.; ,. �: , <br /> DVER THE COUNTER PERMITTING� ,: <(Front of Application Orily) <` ' <br /> Reroofsifshingles Sewers � �'Service�Upgredes�A/G<<----,•Fe�ces{PIoUSurvey/Footage) <br /> Driveways-Not over Caunter if on publfc roadways..needs ROW <br />