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I <br /> i, <br /> �� 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' �� Building Departrnent <br /> 3 <br /> • Data Recelved Phone Contact for PertnitUng — <br /> I � � � � � � � � � � � � � <br /> OwnersName v :��� Q ��+�I F— OwnerPhoneNumber —74a" I��� , <br /> i - <br /> � Owners Address � � �Q Q W Owner Phane Number <br /> � Fee Slmple TiUeholder Name Owner Phone Number <br /> i Fee Simple Titleholder Address <br /> �i JOB ADDRESS � � V{^ 'a � u I 1�-- LOT# �Q� <br /> i' <br /> SUBDIVISION PARCEL IQI� <br /> il WORK PROPOSED NEW coN57R ADD,LI,L' Q SIGN N�o FR�OM PROPERTYT�c�DEMOLISH <br /> i B INSTALL e REPAIR <br /> IPROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK - F ME Q STEEL-Q <br /> I /j,�/� <br /> DESCRIPTION OF WORK (J�'I l <br /> I BUILDING SIZE SC FOOTAGE HEIGHT � <br /> r <br /> i� OBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> I <br /> � QPLUMBING $ <br /> i '�MECHANICAL $ �O �_ VALUATION OF MECHANICAL INSTALLATION -- ��j 7 / <br /> , ��� �� �-� <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> I BUILDER COMPANY <br /> SIGNATURE rtE�isre� Y/ N FEE CURRE� Y/N <br /> Address License# <br /> i ELECTRICIAfV COMPANY <br /> I SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N �cuw�n Y/N <br /> I' <br /> Address Llcense# <br /> MECHANICAL COMPANY L� C.v,�"' - <br /> SIGNATURE REGISTERm �e RREh Y/N <br /> Address �� 0(1 Lfcense# l�l �� Jr ( <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N �curtft�n Y/N <br /> � Address License# <br /> � 1 1 1 1 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 I 1 1 1 I 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 t 1 1 1 t 1 1 1 1 1 I 1 1 1 1 1 1 I 1 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-0-W Pertnit for new consVuction, <br /> Minimum ten(10)working days after submittal date. Required ansite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Faalities&1 dumpster,Site Work Pertnit for subdivisions/large projec[s <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new consWcBan. <br /> Minimum ten(10)working days after submittal date. Requirad ansite,Construction Plans,Starmwater Plans w/Silt Fence Installed, <br /> Sanitary Faalities&1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet complfance <br /> �, SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> I ""PROPERTY SURVEY required far all NEW construction. <br /> i Dlrections:• • • • • • • • • • • <br /> �� Fill out applicatlon completely. <br /> � Owner&Contractor slgn back of application,notarized <br /> If over 52500,a Notice of Cammencement Is required. (AIC upgredes over 57500) <br /> " Agent(for the conVactar)ar Power of Attomey(for the owner)would be someone with notarized letter finm oxmer authorizing same <br /> OVER THE COUNTER PERMIT7ING (copy of contract requlred) <br /> IReroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Caunter ii on public roadways..needs ROW <br /> II <br />'� J <br />� <br /> � <br />