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� � aisaaaoozo City of Zephyrhills Permit Applicatl0fl _ Fax-813-780- 21 <br /> Building Department �� '�� <br /> Date Recefved � �1� _ Z/,4/ <br /> T�r Phone ContactforPertnitt' g <br /> Owners Name 9"r'^L� D �/+ Owner Phone Number ' v Y� �[0 <br /> Owner's Address � tl� Gn o V�r��U Z-� ner Phone Number I <br /> Fee Simple Tideholder Name Owner Phone Number <br /> Fee Simple Tideholder Address ���d c���l <br /> JOB ADDRESS � `��+ 7 1-��G�KJ(iu�' W� LOT# � <br /> SUBDIVISION ��C/C W O PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW cON57R e ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK 1�� � � � �V \ <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> Q BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ /'��`�`�j, <br /> ,`6J a v <br /> d ECHANICAL $ QDO` VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> i 911i171110 161iea � ee ii11P16i1 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address ti License# <br /> MECHANICAL COMPANY U I� — �9�1 � '� ��� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# <br /> I111111111111111111111111111111111111111111111111111111111111111111 <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 submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)camplete sets of Building Plans plus a L'rfe Safery Page;(1)set of Energy Fortns.R-O-W Permit for new construdion. <br /> Minimum len(10)working days after submittal date. Required onsite,ConsUuction Plans,Stortnwater Plans w/Siit Fence installed, <br /> Sanitary Facilities&7 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br />' SIGN PERMIT Attach(2)sets of Engineered Plans. <br />� ""PROPER7Y SURVEY required for all NEW construdion. <br /> Directions:• <br /> Fill out application completely. <br /> Owner 8 ConVactor sign back of application,notarized <br /> If over Sz500,a Notice of Commencement is required. (A/C upgrades aver$7500) <br /> " Agent(for the contrador)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs'rf shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />