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813-780-0020 City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received �`7 Phone Contact for Permitting �� l� � ' <br /> Owner's Name Q/ J Owner Phone Number � �1' �I V L <br /> Owner's Address �� � � �� Owner Phone Number <br /> Fee Slmpie Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ! � � LOT# I( 'ZO <br /> SUBDIVISION OW►9. a� / I�PARCEL IDt� /�-Z�' �DD Jv.l4�OG-!�/7CJ <br /> (OBTAINED FROM PROPERTY TAX NOTILE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ LT � SIGN 0 Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR 0 COMM 0 OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK � 1 �� `1� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> OBUILDING $ ��h /J VALUATION OF TOTAL CONSTRUCTION <br /> V / <br /> DELECTRICAL $ ,' AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � � <br /> /���� <br /> �MECHANICAL $ / VALUATION OF MECHANICAL INSTALLATION / <br /> t <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY / �- �'"� a <br /> SIGNATURE REGISTERED Y I N FEE CURREA Y/N <br /> Address `ud Y�UY�L� (Ol � J�lo�9 License# (..��C d��l O <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE Cl1RRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTEF2ED Y/ N FEE CURREA Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII11111111111111 <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 submiltal date. Required onsite,Conslruction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facliities'8 1 dumpster,Site Work Permit tor subdivisionsAarge proJects ' <br /> COMMERCIAL Attach(3)complele sels of Building Plans plus a Life Safety Page;(1j set of Energy Fortns.R-O-W Permit for new con'struction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpsler.Sile Work Pertnit for all new projecls.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construction. <br /> Directions:' <br /> Fill out application completely. ' <br /> Owner&Contractor sign back of application,nolarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would he someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicalion Only) i <br /> Reroofs I(shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> \ - <br />