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� , <br /> e�saeaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � , i Building Department <br /> i Date Recelve8 � � phone Contact for Pertnittin �3 �� � � � <br /> I <br /> II Owners Name ��N 0 a Owner Phone Number 1 � • <br /> � Owners Address <br /> S�.{J R. Owner Phone Number <br /> I Fee Sfmple Titleholder Name � Owner Phane Number <br /> � <br /> � <br /> ry Fee Simpie Titleholder Address <br /> G <br /> �j JOBADDRESS II F�J �2 LOT# � <br /> i SUBDIVISION S 1 PARCEL IDlE O � �Z I� � ��0 ~pd.� <br /> I (OBTAINED FROM PROPERTY TAl(NOTICE) <br /> WORK PROPOSED NEW CaNSTR ADD/ALT Q SIGN Q Q DEMOLISH <br /> i e INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FR,4ME Q STEEL Q <br /> DESCRIPTIONOFWORK tl`�P��GE INt �jk 1 4J f� SL�AI i �p� <br /> � BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> �BUILDING S . O�b VALUATION OF TOTAL CONSTRUCTION �� �Q D <br /> i QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> � QPLUMBING $ �Cy �� <br /> I� OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> � � <br /> �� QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> � FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> i <br /> BUILDER � � �i1pM� k! �A�NE2 r/tE (a/ �N QOf�Js' <br /> SIGNATURE 6 REGISTERED Y N FEE CURREN Y/N <br /> Address �� t G� {/ �Mv 'r�' License# C / I <br /> � ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> i Address License# <br /> r <br /> � PLUMBER COMPANY <br /> � SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> I <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> � Address License# <br /> 4 , <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> � <br /> Address License# <br /> I111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-0.W Pertnit for new construction, �, <br /> Minimum ten(10)working days after submittal date. Required onsite,Canstruction Plans,Stortnweter Plans w/Silt Fence installed, � <br /> Sanitary FaGlities 8 1 dumpste�Site Work Pertnit for subdivisions/large projects I <br /> COMMERCIAL Attach(2)complete sets of 8uilding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new conshuction. <br /> Minimum ten(10)working days after subm(ttal date. Required onsite,Construction Plans,Slormwater Plans w/Silt Fence installed, � <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance � <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERN SURVEY required for all NEW construction. <br /> ' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Directions: ��_ <br /> Fill out applicaSion completely <br /> pOwner&Contractor sign back of appliradon,notarized <br /> If over$2500,a Notice of Commencement Is required. (AIC upgrades over$7500) <br /> " Agent(for the contractor)or Power oi Attomey(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 shfngles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> IDriveways-Not over Counter if on public roadways..needs ROW <br /> �4 � <br /> i <br /> !� � <br />