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813-780-0020 City of Zephyrhills Permit Application � � ``�, `� Fax-813-780-0021 , � <br /> _ � _ • ___ _,_ , . , Building Departrnent � <br /> - - , � —�_.� <br /> D�2e Recelved � � -/. ' � ' - - - <br /> ;, Phone Contact�f Pe mittin . ..3.�� ��2 b L�� � <br /> � , /) � {p � <br /> Owner's Name , �, ��S � �-'�''���� Owner Phone Number� �L� <br /> Owner's Address �.� � ���- / � �l✓�C:._ . OwnerPhone Number � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholde�Address ID' , <br /> � L � <br /> JOB ADDRESS ✓�l� LOT# <br /> SUBDIVISION PARCEL ID# <br /> , . (OBTAINED FROM PROPERTYTAX NOTICE). <br /> WORK PROPOSED °� NEW CONSTR ' �ADD/ALT Q SIGN Q " Q DEMOLISH - <br /> INSTALL � REPAIR <br /> PROPOSED:USE Q SFR � COMM Q OTHER � <br /> TYPE OF CONSTRUCTION' Q BLOCK-�' Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � 1 � �}CL � <br /> BUILDING SIZE � SQ FOOTAGE Z� HEIGHT � l� <br /> QBUILDING $ -ti:��:.�- �-= :. --.� <br /> `�iY�(� VALUATION'aF;T01'AL COMS1'RUCTION <br /> QELECTRICAL $ .��, AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> -� 1 � ��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> ��S Q ROOFING. Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � �1 FLOOD ZONE AREA �YES � , <br /> BUILDER r � <br /> ` , i �,�/ COMPANY <br /> SIGNATURE / .f%" REGISTERED Y/ N FEE CURREA Y/N I <br />- - -l�ddre�s - --I - -- - --- - - - � Llcense# -- - ----—----- - ---- <br /> ELECTRICIAN COMPANY � <br /> SIGNATURE "' REGISTERED Y/ N FEE GURRE� Y/N <br /> Address , � '.License# � � <br /> PLUMBER COMPANY • - <br /> SIGNATURE � REGISTERED Y/-N FEE CURRE� Y/N, <br /> Address � License# <br /> MECHI4NICAL COMPANY <br /> SIGNATURE � ` � REGISTERED Y:/�N FEE CURRED Y./:N� • <br /> Address ' � � � � Lfcense# . <br /> OTHER - ' � ,COiNPANY <br /> SIGNATURE. '' ' REGIs7EriEo Y/ N .• ` �E Cur�n , Y:/.N.. <br /> Addre�s �. - ° ' � ' License#• � <br /> RESIDENTIAL� �Attacii,(2):PIof;P..lans•,.:(2)sef§�:of�BullBfng`Plans;(1)sef of�Energy�Fortns;;R-O=W°Peririit for new„constnicUon, <br /> �C:�'"��ti <br /> : >�Minimum�.tena(10):.Working;daysyafter:'sutiinittal"d"ate:�.Requlred onslte,�ConsViicdori�Plans;=StormwateF`Plans w/Silt Fence installed, <br /> � � �$anitary�Faciliftes.&�1.;dumpster;-Site^Wark;Permitfor_sutidiv_istons/large_projects`:��:-:��:_ `;. ";.�� - <br /> 'f , i: . .: ..Z«:.... ... .Y�.. .. <br /> COMMERCIAL Attach(3)'�corriplete sets'of Builtling Plens plus a Lffe Safety Page;�(1)set of Energy Fortns.R-O-W Pertnit for new construcUon. <br /> f Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stortnwater Plans w/Sflt Fence Installed, <br /> Sanihary Fadlitles 8 1 dumpster.Site Work Permit for all`newiprcjeots':-All commercial.requlrements must meet compliance <br /> SIGN PERMIT Attacfi"(2)set"s=of Engineer,ed::Plans:';:;;,:;�;; .. .- ,.. : <br /> "'•PROPERTY SURVEY reguired,for:all.,NEW.construcdon.,_ <br /> Directlons: ::;7 . <br /> Flll,out applicatlon completely. - <br /> Owner.&Contractor sign back-of applica8on,notadzed <br /> If over.S2500,a Notice of Commencement Ia requfred. (AIC upgrades over 57500) _ _ <br /> i ' ::i.;;,t.:-�;.;rt.. ' _ <br /> - - ._ _._ ___ <br /> " Agent(for ttie contractor)or:Power�of Atfomey"(fo��tlie owtier)would be someone with notarized letter from owner authorizing same <br /> DVER'THE COUNTER.PERWIITTING �-� -•{Front:of;Application Only)• � � " ' <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PlobSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways.:needs ROW '� <br />,� <br />