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a�saeo-oo2o City of Zephyrhills Permit Application Fax-813-780.0021 <br /> Building Department <br /> � • z • <br /> Date Recelved Phone-Contacf for'Permittin — <br /> Owner's Name ��'/�l� /�._ Owner Phone Number <br /> Owner's Address � � �� /C,/,�/�� �//� (�l� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �j 6 D /v d j�/.,f�'1'JL�— LOT# � <br /> . �< <br /> SUBDIVISION S L.���- Q�%[�1 PARCEL ID# � O 3'e��C �_D 15r���ODOU —��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT Q SIGN �Q Q DEMOLISH � <br /> INSTALL B 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 � Q� O �i G(/1�17 /�I �� � � ��Sl���� S�"1���G� <br /> BUILDING SIZE SQ FOOTAGE C� HEIGHT <br /> QBUILDING $ /1'� 3� VALUATION�OF TOTAL CONSTRUCTION <br /> 6 <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ - � J� `� <br /> � � I �,�n <br /> ��4-� l � rwi' <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION n �� �r.�% / <br /> . - 1 p/yduc, ��1"'" <br /> QGAS [F�� ROOFING Q SPECIALTY � OTHER �� � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO <br /> � <br /> BIDILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N �E Cu�n Y/N <br /> Address Cfcense# —� <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 /> Addres� , License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER �� COMPANY v'"�J�/" O�//"� <br /> SIGNATURE REGISTERED Y/ N . FEE CURRE� Y/N <br /> Address 0 Q� 3� /}Qb CL�` �/i - Llcense# /u--�����`L <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of.Building Plans;(1)set of Energy�Forms;R-O-W Perrnit far new construction, <br /> Minimum,ten(10).working•days after.submittal date. Requtred onsite,Construction Plans;Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Facilitles.&1 dumpster.Site Work Permit for subd(visions/large proJects <br /> COMMERCIAL Attach(3)complete sets of Buildiog Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Pertnit for new consUucUon. <br /> Minimum ten(10)working days'after submithal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Santtary FaciliUes&1 dumpster.Site Work Permtt for all new proJects.All commercial requirements must meet comptlance <br /> SIGN PERMIT Attach(2)sets of Engineered�Plans. <br /> """PROPERTY SURVEY required for all NEW constructlon. _ <br /> Directlons: <br /> FIII out applicaUon completely. <br /> Owner&Contractor sign.back of appllcatlon,notarized <br /> If over 52500,a Notice of Commencement i�required. (A!C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey_(for.the�owner)would be•someone with notarized letter from owner authorizing same <br /> DVER THE COUNTER_P.ERMITTING (Front of Applicatio�n Only)���,�=� :�, <br /> Reroofs if shingles Sewers Service Upgrades A%C'' -.Fences�.(RIoUSurvey/Footage) <br /> Driveways-Not over Counter ifion putilic roadway_s„naeds.ROW�x��-,��•�•` <br />