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s��-zeaaozo City of Zephyrhills Permit Application Fax-a��-7eo-ooz� <br /> Building Department <br /> Date Raceived phone Contact for Pertnitting — <br /> � <br /> Owners Name Owner Phone Number <br /> Owners Address Owner Phone Num6er <br /> Fee Simple Trtlehoider Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS /�+ e� / LOT# �� <br /> SUBDMSION C.F3 PARCELIDq � �d��O� � Dd /D� O�oO� �--+�0 <br /> (OBTAINED FROM PROPERTY TAX N0710E) <br /> WORK PROPOSED NEW CONSIR ADD/ALT Q SIGN Q Q DEMOLISH <br /> e INSTALL e 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 C�. ' /s' <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT �� <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ /�/ !-� <br /> �u��/ <br /> �MECHANICAL $ D� ho VALUATION OF MECHANICAL INSTALLATION <br /> V <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE r�ciS�aen Y/ N �cuw�n Y 1 N <br /> Address License# <br /> ELECTHICIAN COMPANY <br /> SIGNATURE REcis�Ren Y/N �cuw�n Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE r�GiSi�ten Y/N r�Cu�n Y/N <br /> Address Ltcense# <br /> MECHANICAL COMPANY N r// � �+ (L`' <br /> SIGNATURE r�c�s�aEo Y/ F�cuRaen Y 1 N F� A , <br /> Address 3 �u.Q. R� � G/ License# A �/5� �V <br /> OTHER COMPANY <br /> SIGNATURE REGIS7EfiED Y/ N �cuttr�n Y/N <br /> Address License# <br /> 111111111IIIIIIIIIt11111110111111111111111111111111111i111111111111 <br /> RESIDEN'f1AL Adach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new construction, <br /> Minimum ten(10)working days after submittai date. Required onsite,ConsWdion Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facifities&1 dumpster,Site Work Pertnit for subd"rvisions/large projects <br /> COMMERCUll. Attach(3)complete sets of Buiiding Plans pius a Lffe Safety Page;(1)set of Energy Fortns.R-O-W Permit for new construction. <br /> Minimum ten(10)wotiting days after submittal date. Required onsite,Construction Plans,Stormvrater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Wark Pettnit for ali new prnjec[s.All commercial requiremeMs must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br />� ""PROPERTY SURVEY required forali NEW consWction. <br /> DirecUons: <br /> Fip out appliration completely. <br /> Owner 8 ConVactor sign back of appliption,notsrized <br /> If over$2600,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for Ute conVactor)or Power of Attamey(far the awner)wouid be someone wilh notarized tetterftom owner aufhorizing same <br /> OVER THE COUNTER PERMITfING (Front of Apptication Only) <br /> Reroofs iF sfiingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Faotage) <br /> Driveways-Not over Counler if on public roedways..needs ROW <br /> I - <br />