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, .t s�aasaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> - , - �uilding Department <br /> . Dato Recelved phone Contact for Pormittin 3 3 <br /> , Owners Name �}r Owner Phone Number � <br /> 3�a�a r�• <br /> Owners Address t,(,j �}�/t, Owner Phone Number � �$pZ �0�� <br /> Fee Slmple TiUeholder Name Owner Phone Number <br /> Fea Slmple TiUeholder Addrass <br /> JOB ADDRESS o� L-V K�M = E I LOT# � <br /> SUBDIVISION � PARCEL ID# <br /> (OBTAINED FROM PROPERTV TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALI REPAIR <br /> PROPOSED USE Q SFR, Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �E fRC`'�I'1A�_T Z.1�.T�L+. (�(�-� �� , <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 /> �PLUMBING $ � �z <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER ,//s� �Q J COMPANY � S UIh�/h 1/7C • <br /> '�P SIGNATURE `C/r��� REGISTERED Y/ N F CURRE� Y/N <br /> "�� Address ?V•�ip a7� T f� 3.� License# y f <br /> MECHANICAL COMPANY —� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y J N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREh Y/N <br /> Address License k <br /> � i � � i � � � � � i � � � � iii � � � ii � ie � � � � i � � � � � i � ii � � � i � � � ii � � iii � i � � � ii � � � � � � <br /> RESIDENTIAL Attach(2)Plot Plens;(2)sets of Building Plans;(1)set of Energy Fortns;R-0.W Pertnit for new consUuction, <br /> Minimum ten(10)worldnp days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Siit Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sels of Building Plans plus a Life Safety Page;(1)sei of Energy Fortns.R-O-W Permil for new construdion. <br /> Minimum ten(10)warking days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence instalied, <br /> Sanitary Facilities&1 dumpster Site Work Pertnit for all new projects.All commercial requirements must meet wmpliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for ail NEW construdion. <br /> Directlons;• <br /> Fill out applicadon completety <br /> Owner 8 Contrador sign back of application,notarized <br /> If over 52500,a Notice of Commeneement Is required. (AIC upgrades over S7b00) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized lerier from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Nol over Counter if on public roadwrays..needs ROW � <br />