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i <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> I .. , � <br /> . Building Department <br />� Date Received // • ��'`� � Phone Contact for Permitting — <br /> Owner's Namll ��{�2 0� Owner Phone Number <br /> Owner's Addrless Owner Phone Number <br /> Fee Simple Ti leholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> I JOB ADDRESS I �"e 1�� d'�O� � LOT# � <br /> suauivisio PARCEL ID# D a 2l0' �,� —G� l b—6� �p p�-C�d p � <br /> i (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED . NEW CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> I e INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE'OF CO�NSTRUCTION Q BLOCK • Q FRAME 0 STEEL Q <br /> DESCRIPTIO OF WORK � Gl. �D � �v WL <br /> BUILDING SI I E SQ FOOTAGE� HEIGHT <br /> il • <br /> QBU�LDING $ VALUATION'OF TOTAL CONSTRUCTIO � <br /> ELECTRICAL $ (/jJ AMP SERVICE PROGRESS ENERGY Q W.R.E.C. <br /> ,5�D <br /> QPLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION rA�� <br /> ^V�� <br /> �GAi Q ROOFING Q SPECIALTY � OTHER �( ` <br /> FINISHED F IOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> �4ddres License,# <br /> , ELECTRICI COMPANY , �" �C. <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� / <br /> � Addres License# (�C � <br /> PLUMBER., � COMPANY- <br /> SIGNATURE RE�isreReo Y/ N FEE CURRE� Y/N <br /> Addres License# � <br /> MECHANICAL � COMPANY <br /> SIGNATURE � REGISTERED Y/ N FEE CURREn Y/N <br /> Aild�es License# <br /> �. � <br /> OTHER �' ' COMPANY <br /> SIGNATURE r ' REGISTERED Y/ N FEE CURRE� Y./N <br /> , .,�. .� , <br /> Addres I . � • _ � License# <br /> RESIDEPITIAL � Attach�(2)Plot P.lans;�(2)'sets of�Buildirig�Plans;(1)set of Energy Forms;R-O-W Permit for new.construction, <br /> . - ,�_ � Minimum�ten�(�10)working.days afte�subinittal.date. 'Required onsite;Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> ;_� Sanitary Facilities.&1�.dumpster,;Site;W,ork�Rermit for subd'i'visionsAarge projects <br /> � COMMERCI, Attach(2)complete'sets of Building Plan's plus a Life Safery Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucGon 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 PERMIT i4ttacti(2)sets of Engineered Plans. <br /> *"*PROPERTY SURVEY required for all NEW construction. <br /> Di�ections: I -� : . , <br /> Fill out a plication completely. <br /> OwneF&�Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> •' Agent(for the contractor)or Power of'Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> I <br /> OVER THE COUNTER PERMITTING (copy of contract-required) <br /> Re�oofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter:if"on'po6lic��oad""ways.:needs ROW .-. .. .- , <br /> � , • , <br /> , . . , �'4,,�.� <br /> 1�_ i�..,. t.,�.,��,�.,.,' ,.,:t'.,:�r:. �. .. � <br /> il � _�--�. ...�.. . .,..,.: <br />