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y.• •� <br /> ��eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting � (�2 _Va� <br /> Owner's Name �Q,�l 11 Owner Phone Number <br /> Owner's Address 5 �br1 t1�°,. ���� � Owner Phone Number <br /> Fee Simple Trtleholder Name OWner Plione Number � <br /> Fee Simple TlUeholder Address <br /> JOB ADDRESS �c..—SD � {� << �Y'v�. pr-Z�� U 3�� LOT# � <br /> SUBDIVISION Pa��.►��i i T�vr �Q PARCEL ID# O2 2�Z I ��OO^O��OI� <br /> (OBTAINEO FfiOM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> �NSTACL REPAIR <br /> PROPOSfDUSE .� SFR � COMM •� OTHER <br /> TYPE OF CONSTRUC110N Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK c�h.( �y[� �Q,� <br /> BUtLDING SIZE SQ FOOTAGE� HEIGHT � <br /> �BUIL�ING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP.SERVICE Q FROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ (�h` G]� <br /> � ( �j l 1 <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER �( COMPANY CL l SCV L V �.O(�� <br /> SIGNATURE � REGISTERED 1 N FEE CURRE� I N <br /> Add�ess V-1 Q I:ICL�,� �� Z S c.7C}.��L� L(cense# l�� �J V� C� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE cURREn Y!N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATl1RE REGISTERED Y!N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License�i <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y] N FEE CURRE� Y 7 N <br /> Address license# <br /> IIIIIIIIIIIIIIillllllllllllllllllllllllllllllllllllltllllilllllllll <br /> RESIDENTIAL Attach(2)Plol Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minlmum ten(10)working days after submittal dete. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities&1 dumpster;Site Work Pertnit for subdivlslonsllarge projects <br /> COMMERCIAL Attach(2)complete sets of Buildfng 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 submfUal date. Required onsite,Constructlon Plans,Stormwater Plans wl SIII Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commerclal requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans, <br /> ••"PROPERN SURVEY requfred for ail NEW consWcUon, <br /> Directions:• <br /> Ffl aut appfication complefefy. <br /> Owner&Contractor sign back of application,notarized <br /> If aver$2500,a Notice oi Commencement Is required. (AIC upgrades over$7500) <br /> `• Agent(for the contractor)or Power of Attorney(for the owner)wouid be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIITING (copy of contract required) <br /> Reroofs if shfngies Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />