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I <br /> I <br /> i 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 � <br /> Bullding Department ' <br /> e , . <br /> Date Received t^ 3 � _��� � <br /> � I �yc Rhone Contact for Pertnitting <br /> � <br /> Owner's Name Owner Phone Numher <br /> , Ul <br /> Owner's Address 12�►y2 C��FG�k►pn t�d. c �O Owner Phone Number <br /> i <br /> � <br /> Fee Simple Titieholder Name Owner Phone Number <br /> � <br /> i <br /> i Fee Slmple Titleholder Address � <br /> JOB ADDRESS 3p�/—S �-�iC�Q �2�� LOT# � <br /> � SUBDIVISION PARCEL ID# 1(`���ZIY ^K7.�O^ I <br /> (OBTAINED FROM PROPERTY TAX NOTICE) � <br /> WORK PROPOSED � NEW CONS7R e ADD/ALT 0 SIGN Q Q DEMOLISH � <br /> INSTALL REPAIR I <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION , Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK 6 h r � � "� '� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING $ p � <br /> Q VALUATION OF TOTAL CONSTRUCTION i <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � , /��Q <br /> � ��l% <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � � <br /> I_ � I <br /> QGAS Q ROOFING Q SPECIALTY � OTHER �y <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER L.R'�(��(�� COMPANY � ��"�� <br /> SIGNATURE � � �"�V'—� REGISTERED N F CURRE� /N <br /> Address License# �� �3� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY i <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIII111111111111111111111111111111111111111 � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construcfion, � <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, ' <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisionsllarge projects � <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new consWction. � <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater 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 Ptans. ! <br /> ••••PROPER7Y SURVEY required for all NEW construction. <br /> i <br /> Dlrectlons:• <br /> Fill out application completely. � <br /> Owner 8 Contractor sign back of application,notarized ' <br /> � If over$2500,a NoNce of Commencement Is requlred. (AIC upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the ownerj would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMI7TING (copy of contract required) ' <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIotlSurveylFootage) <br /> i <br /> Driveways-Not Over Counter if on public roadways..needs ROW <br /> I � <br />