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e+y,-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> .. � Building Departrnent <br /> Date Recelved 13 J�� — ��� <br /> Phone Contact for Permitting <br /> Owner's Name ��"1 �C ��-�-+ � '�"I"� Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Rhone Number <br /> Fee Simple Titleholder Address - <br /> JOB ADDRESS �� �L � G��, l� � � 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 e REPAIR <br /> PROPOSED USE , Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION . Q e BLOCK � Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK ��r� �I O{� CU In����CSj� . <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> QBUILDING $ •"'�":`".' -';�� <br /> , VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. - <br /> �PLUMBING $ C�/�r� �� <br /> ��� �UlJ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS 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 /> ELECTRICIAN -� COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N " <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE . REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY J��� ��j C� ,!�Y /Q� <br /> SIGNATURE REGISTERED Y/ N . FEE CUR EA Y/ <br /> Address �a da . o�� License# S � J��Ja . <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets=of:Buililing'Plans;(1)set of Energyforms;R-O-W Pertnit for new conshuction,. <br /> ,Minimum,ten(10),working;days,after.submittal date. Required onsite,Constructlon Plans,Stortnwater'Plans w/Silt Fence installed, <br /> $anitary Facilities&1 dumpster Site Work:Pertnit for subdivisionsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Buildirig Plans plus a Life Safety Page;(1)set of Energy.FoRns.R-O-W Permit for new construction. <br /> Minlmum ten(10)working days'after submitNal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facili8es 8�1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach"(2)sets of Engineered Flans..� � � <br /> "`••PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Ffll out applicaUon completely. ; :, � ` , �, , � , . <br /> Owner&Contractor sign back of applicatlon,-notarized - ;' " _ � <br /> If over 52500,a Notice of Commencement is required. (AIC upgrad`es over 57500) , <br /> " Agent(for the contractor)or Power of Attori�ey(fo�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 /> Drivewrays-Not over Counter if on public roadways..needs ROW <br />