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s�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> • • Building Department <br /> Date Recelved• 3 �L� _ �� <br /> Phone Contact for Permitting i i <br /> ; Owner's Name � (� � �" l V � Owner Phone Number U'"..D <br /> ` Owner's Address � � Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> � <br /> I ' ' <br /> Fee Simple Titleholder Address <br /> r JOB ADDRESS \ l�l.(,l, - �I I� � � LOT# � <br /> i <br /> � SUBDIVISIOIV �,t,VL PARCEL ID# � ( �O '�L� <br /> , <br /> i � (OBTAINED FR�OM PROPERTY TAX�NOTICE)DEMOLISH <br /> � WORK PROPOSED , NEW CONSTR ADD7ALT SIGN I <br /> I � INSTALL e REPAIR <br /> PROP..OSED USE. Q SFR Q COMM 0 OTHER . <br /> TYPE'.OF CIONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK l V Y - ��� LP� � � <br /> BUILDIWG ISIZE SQ FOOTAGE� HEIGHT �. � � �r <br /> IIUILDING $ � VALUATION'OF TOTAL CONSTRUCTION `��� � �' " x� �� <br /> I ' 2 ce,�e.s �k 5'w� <br /> I QiL.ECTRICAL $ AMP SERVICE � PROGRESS ENERG Q W.R.E.C. i <br /> I QPLUMBING $ I <br /> I ; �� <br /> � QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� <br /> � \ <br /> " QGAS Q ROOFING Q SPECIALTY 0 OTHER ' I <br /> '; FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> ` <br /> � � �� � � <br /> 1 BUILDER I - '- COINPAIdY <br /> i i SIGNATURE REGISTERED Y N FEE CURRE� Y/N <br /> jAddress 4 . T ��� License# <br /> r <br /> I I <br /> ELECTRI.CI�PI COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrel s License# � � <br /> � I <br /> i <br /> I� PLUMBER! COMPAfdY <br /> SIGPIATURE REGISTERED Y/'N _ FEE CURRE� Y/N <br /> ; Address License# <br /> ; � <br /> I MECHANICAL COMPAIdY <br /> I SIGIdA'I'URI�'^ � REGISTERED , Y/ N FEE CURRE� , . Y/N <br /> I , <br /> i . <br /> Addre'ss`- - L-icense.# <br /> � ,�.,,:, .. <br /> � ' <br /> � , OTHER�' ` :- • CORAPAWY <br /> � `�SIGNATURE'�= �: • REGISTERED Y/ N FEE CURREK . Y/N <br /> � . .` _,c, I� <br /> � <br /> Address�: - License# <br /> ��'�=.RESIDENTIAL..; �Attacfi�;(2)�Plot':Plans�;.'(2)�sets•of�Buildirig-Plans;(1�)'set of�Ene�gy'Form§;R;O=W,Permitfor new.construction, <br /> '' �-.:Minlmum;ten;.10, workin ;iia"s'afte�§utimittal:date. Re uired onsite;'Con`stniction Plans,'Stormwater Plans w/Silt Fence installed, <br /> u.. .:....,: �. .),_„ 9 Y 4� <br /> � • `Sanitary;FaciUaes:&�;1_dumpster;�Sife�Work Fermit foc,subdivisions/large projects . • <br /> :i_.:COMMERCIAL Attach�(2)�carriplete`sets`of'Building�Plans 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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> � � . Sanitary FaciliUes 8�1 dumpster.Site Work Permit fo�•all-new p�ojects.All commercial requirements must meet compliance <br /> ; �:SIGN�PERiVIIT �Attach(2)sefs of;EngineeredPlans:<<- <br />� i .;, i "'"*PROPERTY SURVEY required fo[all NEW.construction._ <br /> �' - �- <br /> '''-Dl�ectlons:I -.>:;.,<<.:.: <br /> ' � '�� "Fill out�application completely. <br /> � Owner 8 Contractorsign back of application,notarized <br /> If over,�$2500,a Notice.of Commencement is required. (A/C upgrades over$7500) <br /> "'" Agent(for the°con4�actor}orPower of Attomey(for tFie owner)would be someone with notarized letter from owner authorizing same <br /> ' �;:�OVER�THE'COUNTER'PERMITTING. (copy.of.contract-required) " " , <br /> :=Reroofs if sti�ingles Sewers Service Upgrades A/C Fences(Plot/SurveylFootage) �i <br /> Drivevuays-Not over Counter if on public roadways..needs ROW � <br />