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a�aasaoozo City of Zephyrhills Permit Application Fax-s��-�eaao2t <br /> y . � Building Departrnerrt <br /> Date Received Phone CoMact for Permittin <br /> owner's Name Di1�CJ N%C� Owner Phone Number � 'y�i ",7� <br /> Owners Address ���� � a d7� �' Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Simpla TiUeholder Address <br /> JOBADDRE55 �� e � I7 � �I� C ,7��I LOT# � <br /> SUBDIYISION PARCEL ID# /1- Rl-GD/ "� 7Q��l � <br /> (OBTAINED FROM PROPERTY TW(NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL 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 K .Li� ' � I /� � G. <br /> BUILDINO SIZE SQ FOOTAGE O � HEIGHT � <br /> QBUILDING $ � D VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE �Gis�r�o Y! N �ECUaaEn Y!N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEe CurtREn Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGI5TERED Y!N �e curt�n Y/N <br /> Address Lice�e tF <br /> MECHANICAL COMPANY <br /> SIGNATURE REGIS7ERED Y/N FEE CuaaEn Y/N <br /> Address License# <br /> ) ♦ <br /> OTHER COMPANY �v/ <br /> SIGNATURE rtEGis�Ren /N �e Cu n Y/N <br /> Address C'/'aia:z �j� License# <br /> tllllltlllllllllilllllllllllllllllllllllllllllllltlllllllllllll1111 <br /> RESIDEtdTIAL Attach(2)Pfot Plans;(2)sets of 8uilding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required ansite,ConsWction Plans,Stortnwater Plans w!Sitt Fence installed, <br /> Sanitary Faalities 8 1 dumpster,Site Work Pertnit for subdivisionsllarge projects <br /> COMMERCIAL Attach(2)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new construetion. <br /> Minimum ten(10)woAcing days after submittal date. Required onsite,ConsWction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Pertnit for all new projects.All commerdaf requirements must meet compliance <br /> SIGPI PERMIT Attach(2)sets of Engineeretl Plans. <br /> ""PROPERTY SURVEY required for all NEW conshuction. <br /> Directions:• <br /> F01 out applicatlon completely. <br /> Owner&ConUactor sign back of application,notarized <br /> If over Sz500,a Notice of Commencement is requijed (AIC upgrades over s'7500) <br /> " Agent(tor the conVactor)or Power of Attomey(for the owner)wouid be someone with noterized Ietter from owner authorizing same <br /> OVER THE COUNTER PERMITi1NG (copy of conUact required) <br /> Reroofs if shingles Sewers Service Upgredes A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />