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� . <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> � `Date Received Phone Contact for Permitting <br /> Owner's Name f � C6�C����1 1 Owner Phone Number J`S� Z� �/ � <br /> Owner's Address V (/ �f �/'�1�4s �f Owner Phone Number <br /> _ Fee Simple Titleholder Name Owner Phone Number <br /> �, <br /> � Fee Simple Titleholder Address <br /> JOBADDRESS � /' t S LOT# � <br /> SUBDIVISION (1 V� � PARCEL ID# � '� Q `�(� d <br /> (OBTAINED FROM PROPERTY TA%NOi10E) <br /> WORK PROPOSED e NEW CONSTR e ADDlALT Q SIGN Q MOVE 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q OTHER <br /> DESCRIPTION OF WORK (� , [CL �I ' I�1V1C <br /> / <br /> BUILDING SIZE SQ FOOTAGE IZ L HEIGHT <br /> Q�!BUILDING $ µVALUATION OF TOTAL CONSTRUCTION <br /> Y <br /> Q ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY � W.R.E.C. <br /> Q PLUMBING $ <br />, Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS Q ROOFING 0 SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES QNO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE �cis�a� Y/ N FEE CURRENT Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURRENT Y/N <br /> Address License# <br /> OTHER COMPANY f� G M . <br /> SIGNATURE REGISTERED /N FEE CU ENT Y/N <br /> Address �d � License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns <br /> Minimum ten(10)working days after submittal date. Required onsite,CansWction Plans,Sanitary FaciliUes&1 dumpster <br /> COMMERCIAL Attach(3)sets of Building Plans;(1)set of Energy Fanns. <br /> Minimum ten(10)working days after submittal date. Required onsite,Canshuction Plans,Sanitary Facilities R 1 dumpster <br /> All commercial requirements must meet compliance. <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consWdion. <br /> Directions: v <br /> Fill out application completely. <br /> Owner&Contrador sign back of applica5on,notarized <br /> if over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> "' Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT'fING (Front of Appliqtlon Only) <br /> Reroofs Sewers Service Upgrades A!C Fences(PIoUSurvey/Footage) <br /> DrivewaysNot over Counter if on public roadways..needs ROW <br />