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813-780-0020 City of Zephyrhills Permit:�Application � FaX-s�saeaoo2� <br /> � , , � Bullding Departrnent , , <br /> Date Recelv�d ° Phone Contact for Permittln "' "." � — <br /> Owner'a Nam I � ,� I(� (/1/ti Owner Phone Number , <br /> Owner's Addross Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> ;� <br /> Fee Simple Titl�holder Address • <br /> JOB ADDFtESS � h LOT# � <br /> SUBDIVISION PARCEL ID# - ��(��� �(�( � '` G��G��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP�SED •NEW CONSTR ADD/ALT Q SIGN Q � Q DEMOLISH <br /> B. INSTALL B REPAIR <br /> PROPOSED; ISE - Q SFR. Q COMM � OTHER <br /> TYPE OF CORISTRUCTION Q BLOCK " Q FRAME Q STEEL" [] <br /> DESCRIPTIO I OF WORK' � U '� D �jijiL <br /> BUILDING'SIZE' SC1 FOOTAGE C� . HEIGHT� . <br /> OBUIi DING $ VALUATION�OF TOTAL CONSl`RUCTION <br /> L�CTRICAL $ "� AMP SERVICE Q PROGRESS ENERGY [� W.R.E.C. <br /> OPLUMBING $ — <br /> � ���� <br /> QME�HANICAL $ VALUATION OF:MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q • OTHER � � ��� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANIf� � " <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Addre�� � License# � <br /> ELECTRICIAAFII. COMPANY -„eG (r(L °`" (/�( 'e�-!'/ p <br /> SIGNATURE �` REGISTERED / N FE CURRE��� 'Y/N <br /> AdcYress License# ���.C�U d �� �p� <br /> PLUMBER COAAP.ANY <br /> SIGNATURE" REGISTERED Y/-N FEE CURREn , Y�/N <br /> Addre I .License# <br /> MECHANICW:` COMPANY <br /> SIGNATURE� ' REGISTERED Y./_N FEE CURRE� Y/�N <br /> Address - - � ' - � " � ' , � Ciceqse# <br /> OTHER ' - �- '.COMPAPIY, , <br /> SIGNATURE -., ' � - � ' - � ' Re�Is7E�o Y/ N,, FeE CUR�n•� Y/N <br /> Address _ License# ` <br /> � �,.. _ ,,.., . <br /> RE3IDENTIAL: Atta,cFi:(2),Plo.f Plans;a(2)sets:of:Buildi'ng+Plans;'(.1)sef of-Energy=Fonns;�R=O=W'PeRriit for new constrtiction, <br /> ;�-Minimum.ten;(:10)�working;ifays_after,�submittal"date.=Required ons(te,�'ConstnictlomPlans;Stormwater'Plans w/Sllt Fence installed, <br /> � ���SaniEary FaGltUes.&;l;dumpster,�Site�Work�P,>ermit;for su6divislon"sAarg"e.pro)ects '• ' ' � �; ` _ � <br /> - COMMEP.�'l�4i. Attach(3)�complete`sets`of Buildirig Pians�plus a Life�Safefy Page;(1)set of Energy Forms.R-O-W Permit for new construction.- <br /> I Minimum ten(10)working days'after submithal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, - <br /> Sanitary FaciUUes 81 dumpster.Site Work Permit for all new projects:All commerctal requlrements.must meet complfance <br /> SIGN PERMIT Attach"(2)'sets of Enginee[ed;Plans:.. : � .. � - <br /> I "'•PROPERTY SURVEY required for all,NEW construction. .. , . <br /> - - .,___.. , <br /> Directlons: I .,��:: :, u - <br /> F(II out applicadon completely. ; <br /> Owner 8� Contractor sign back of appltcatlon,notarized � <br /> If over�2500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> " Agent(I r the�contractor)or Power of Attomey(for tFie owrner)would be someone with notarized letter from owner authorizing same ' <br /> DVER THE�OUNTER,PERMITTING - - �(Front ofiApplicatlon Only) - - <br /> Reroofs if sh�ngles Sewers Service Upgradas A/C Fences(Plot/Survey/Footage) - <br /> Drivers I ya-Not over Counter if on public roadways:.needs ROW <br />