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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ` Building DepaRment <br /> • Date Received lr Za� Phone Contact for Permitting 67 a�� - Sy� <br /> �^ /� <br /> Owner's Name r T� Owner Phone Number <br /> Owner's Address 30�oc—I r �/(L(.tJ �`e- I V Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Slmple Titleholder Address <br /> JOB ADDRESS LOT# � I <br /> SUBDNISION PARCEL ID# �S a5�a�'0��� '� d�`���v � <br /> (OBT/UNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK l�� 'V� I � �� � I Ir rl'� S� � Q ' � <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT II <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION � <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �� /� /� v <br /> � ,� / <br /> �MECHANICAL $ ���? .� VALUATION OF MECHANICAL INSTALLATION , <br /> J <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N <br /> Address License# <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 /> IAddress License# <br /> MECHANICAL COMPANY � I.FJI�I�Ii��IYIIYL � � <br /> SIGNATURE REGISTERED Y! N FEECURRE� N <br /> Address License# I..RC� ��� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Pertnit for new construction, <br /> Minimum ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Pertnit for ail new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERI'Y SURVEY required for all NEVH construction. <br /> Directions:• <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> " Agent(for the conVactor)or Power of Ariomey(for the owner)would be someone with notarized letter from owner authorizing same % <br /> OVER THE COUNTER PERMITTING (copy of conVact required) <br /> Reroofs if shingles Sewers Service Upgrades AIC Fences(Plot/Survey/Footage) - <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> — - J <br />