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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � , Bullding Department <br /> Date Received phone Contact for Permitling — <br /> -n-�-�-�-�-�-j- - - - �'7'1'1-1 - - <br /> Owner's Name �l t �� YY> Owner Phone Numbe► (Q/ �3 ' � � <br /> Owner's Address �J7 � ���� �PL "2� Owner Phona Number <br /> Fee Simple Titlaholder Nama Owner Phone Number <br /> Fee Slmple Tltlaholder Address <br /> JOBADDRESS ��y�q �,���y 6P('y, �V�� Z��hy rhl��S �.�is1(� LOT# —1 ( <br /> SUBDIVISION �7' '1 F Zf.)t1,S PARCEL ID# c�'7'oZ,�',� -6(�� G�d —( � C7 <br /> (OBTAINED FROM PROPERiY TAX NOTICE) <br /> WORK PROPOSED e N TALLS7R e REPAIR � SIGN Q Q DEMOLISH <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK /?C �. ��r8 1� S f S�''c'% � ,T <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> �AECHANICAL $�y�Q.L ' VALUATION OF MECHANICAL INSTALLATION <br /> J <br /> QGAS � 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 /> 31GNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# <br /> MECHANICAL COMPANY /Yr •` + G I��l e G <br /> SIGNATURE � REGISTERED Y/ N FEE C n Y/N <br /> Address C t , D �0�3� License# C�CO <br /> OTHER COMPANY <br /> SIGNATURE REOISTERED Y/ N FEE CURRE� Y/N <br /> Address Lfcense# <br /> IIIIIIIIIIIItlllltlllllllllllllllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(7)set of Energy Forms;R-O-W Pertnit for new canstruction, <br /> Mfnimum ten(10)warking days aker submfttal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence(nstalled, <br /> Sanitary Facilitfes&1 dumpster;Site Work Permit for subdivisfons/large projects <br /> COMMERCIAL Attach(2)complete sets of Bullding Plans plus a Llfe Satety Page;(1)set of Energy Fortns.R-O-W Permft for new constructfon. <br /> Minimum ten(10)working days after submittal date. Required onsile,Construction Plans,Slortnwater Plans w!Sflt Fence installed, <br /> Sanitary Facllilies&1 dumpster.Sile Wark Permit for all new proJects.All commerclal requirements must meet complience <br /> SIGN PERMIT Attach(2)sets of Engfneered Plans. <br /> ""PROPERTY SURVEY requlred for all NEW conslruction. <br /> Directlons: <br /> Ffll out appiication completely. <br /> Owner&Contractor slgn back of applicatfon,notarized <br /> I(ovar 52500,a Notice oT Commancement Is requlred. (AIC upgrades over 57500) <br /> " Agent(for the conlraclor)or Power o(Attomey((or lhe owner)would be someone with nolarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract requlred) <br /> Reroofs I(shfngles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not ovar Counler If on public roadways..needs ROW <br />