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; ' <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , Building Department <br /> � <br /> ^II Date Received <br /> � TTr Phone Contact for Permittin -- <br /> r t) l <br /> li Owner's Name r GI� v Ql e.�.t� Owner Phone Number b 1 `���` ��b� <br /> iiOwner's Address J(J � � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> � Fee Simple Titleholder Address <br /> � � �{'S ('o� v� 0 <br /> JOB ADDRESS LOT N <br /> I ? <br /> i SUBDIVISION �t� �� PARCELID# ���+� I � DOI� (3�Q��' (7II O <br /> (OBTAINED FROM PFiOPEHTV TAX NOTICE) <br /> I WORK PROPOSED e NEW CONSTR�DD/ALT 0 SIGN Q � Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM 0 OTHER <br /> TYPE OF CONSTAUCTION Q� BLOCK Q FRAME 0 STEEL Q <br /> 1� DESCRIPTION OF WORK —1 � ( � �� S J�� �� c/ G � re Q ��uG` ���� <br /> d <br /> BUILDING SIZE SO FOOTAGE ���0 HEIGHT � <br /> QBUILDING $ VALUATIONOFTOTALCONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> � MECHANICAL $y � VALUATION OF MECHANICAL INSTALLATION �`Z � �� <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER �l� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> � --710ioailifliiil Ofloatlllliti.� Y..t3..7 8-.7 i i tii i 7itili 77 ii- <br /> I BUILDER COMPANY <br /> SIGNATURE REGISTERED Y I 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 REGISTEflED Y I N FEE CURRE� Y/N <br /> Address License ii <br /> MECHANICAL �I�,. OMPANY O ��� ( � <br /> SIGNATURE f �' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � l 7 ~� � License# (J 1 � % <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence i�statled, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projeds <br /> COMMERCIAL Attach(2)complete sets of Building Plans ptus a Life Safety Page;(1)set of Energy Forms.R-O-W Permft for new construc[ion. <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 PermR for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> *'"'PROPERTY SURVEY required for all NEW construction. <br /> I..FFI��1-�i..�...-q..r...r� <br /> Directions:• _ <br /> Fill out application completely. <br /> Owner&Contractor sign back of apptiption,notarized <br /> If over$2500,a Notice of Commencement is required. (q/C upgrades over$7500) <br /> `' Agent(for the contractor)or Power of Attorney(for the owner)would 6e someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMII"fING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurveylFootage) . <br /> i <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />