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813-780-0020 City of Zephyrhills Perrnit Application Fax-813-780-00�� <br /> Building Department � <br /> I � <br /> Date Received ' <br /> Phone Contact for Permitting �• � ���-Z-S�v � <br /> ���'. f <br /> Owner's Name ;�-��l � _�v •sS� �c-� Owner Phone Plumber .3, �7.3• 5��� <br /> Owner's Address l � ZS�, I�/dil e/L �- � a� � Owrner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS � ' r 7��0'��i Z-" 7�� �f `-377-3��7�� � LOT# � <br /> SUBDIVISION W��nf I� �'� PARCEL ID# <br /> I (OBTAINED FROM PROPERTY TAX NOTICE) � <br /> WORK PROPOSED Bj .. NEw CONSTR B ADD/AlT 0 SIGN � Q DEMOLISH <br /> I INSTALL REPi41R <br /> PROP.OSED USE �.��Q COMM 0 OTHER <br /> TYPE:'OF CONSTRUCTION i BLOCK �• Q FRAME STEEL Q <br /> .. ' .r �A� � <br /> DESCRIPTION OF WORK ���� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT • <br /> �BUILDING $ I �� ���, VALUATION'OF TOTAL CONSTRUCTION <br /> � <br /> QEL.ECTRICAL $ AMP SERVICE PROGRESS ENERGY Q W.R.E.C. <br /> � <br /> QPLUMBING $ '�i, <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATIOfV <br /> I <br /> D;GAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS 'I FLOOD ZONE AREA �YES NO <br /> I <br /> I <br /> BUILDER � COMPANY <br /> SIGNATURE - �( �� � C.-%����"`� �t'REGISTERED Y/ N FEE CURRE� Y/N <br /> Addross I License# <br /> ELEC,TRICIAN COMPANY � ltv-x�r�� J ��-- .,�?G . <br /> SIGNATURE I REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 3�.�/��y � — 2� .- i ( .FJ• � License# U � Z <br /> P.LUII�BEId. y�� _ COMPANY� � a" ' � �, � i� ' C i �-'�`'�� <br /> SIGNATURE - �'�-`-'�+ Z� REGISTERED -/ N FEE CURRE� Y/N <br /> Address � � 'b I � � _ � Z License# ��rZ/ � ��.�Q�i <br />_ MiECHANICAL' y�� I� COMPANY ��1�.S S L L <br /> SIGNi4TURE' i� REGISTERED Y/ N F .CU RRE� Y/N <br /> � � ' I <br /> aaa�ass r YYY/�/ i c�ov /Z� 2`���S �3� l License# CAC� Y-�!`' �j' � <br /> ;;: , ... i <br /> OTHER'� "-`` � i COIIAPkNY <br /> SIGNATURE�.` .• . I ' REGISTERED Y/ N FEE CURREK Y/N <br /> t;, .�:• ;, .,, _ <br /> Address,:- =I' . ' ' ' License# <br /> y:, . <br /> ;'�;RESIDENTIAL;�:� Attacli.;(2)-:Plof P.la�ns;"(2)�"sets'of Building°Plans;(1�)'set of Energy,Fortns;R;O-W Permit.for new,construction, <br /> - � �_- Minimum,ten;(;10):working`rdays afte�su6mittal;iiate."Required'bnsite;Constriiction Plans,Stormwater Plans w/Silt Fence installed, <br /> ,. `,::;:.;'s-t�,z _, ..- , , <br /> _ Sanitary:FaciliNes;&;a1�dumpster;Sife:Wor,k Permitfor..subdivisionsAarge.projects� ` ' <br /> =_�:COMMERCIAL Attach(2)�complete sets of'Buildirig Plans'plus a Life Safety Page;(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 installed, <br /> Sanitary Facilities�&1 dumpster.Site Work Permit"fo�all-new projects.All commercial requirements must meet compliance <br /> �;:SIGN'PERAAIT Attacli(2jsetsof;EngineeredPlans•� <br /> - """PROPERTY SURVEY required for aII.NEW construction. , � <br /> - r --• - <br /> �:-Uirections: �- � �, � <br /> Fill-out application completely. <br /> Owner 8 Contraotor sign back of application,notarized <br /> If over$2500;a Notice of Commencement is required. (A/C upgrades over$7500) <br /> "'"' i4gent(for�#fie�contFactor)orPower`of Attomey(for the owner)would be someone with notarized letter from owner authorizing same " <br /> �;,:OVER.THE COUPITER_RERIVIITTING. (copy of contract required) ` <br /> =Reroofs if sliingles Sewers �Service Upgrades A/C Fences(Plot/Sun.�ey/Footage) <br /> Driveways-Not over Counter if on public roacJways..needs ROW <br /> \ <br /> I <br />