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813-780-0020 City of Zephyrhills Permit Application Fax-813-780.0021 <br /> � Building Department <br /> Date Received . � 2 �g� _ j��� <br /> � := Phone�Contact�for.�Perrralttin � <br /> Owner's Name ��� �Us Owner Phone Number t��� •��� ' }zC'� <br /> Owner's Address v D �7./�Ll � 1 V� Owner.Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Stmple Tltleholder Address <br /> JOB ADDRESS LOT# � <br /> SUBDIVISION PAFtCEL ID# <br /> (OBTAINED FROM PROPERTYTAX NOTICE) <br /> WORK PROPOSED : NEW CONSTR ADD/ALT [�` SIGN' Q Q DEMOLISH <br /> _B. INSTALL B 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' " ��C L��� �'1 I66 h ��-;—j <br /> BUILDING�IZE � �`SQ FOOTAGE� ,HEI,GHT� <br /> QBUILDING $ VALUATION:'dF'TOTAL CONSTRUCTION <br /> QELECTRICAL $ � AMPSERVICE Q �PROGRESS'ENERGY Q W.R.E.C. <br /> OPLUMBING - $ ' ��5� <br /> QMECHANICF►L $ VALUATION OF�MECHANICAL INSTALLATION � � <br /> QGAS Q ROOFING .Q SPECIALlY Q OTHER� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES. ,NO <br /> � - <br /> BUILDEft , COMPANY= <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/�N�' <br /> Addrea� License# <br /> 4: � <br /> ELECTRICIAN; - COINPANY <br /> SIGNATURE � REGISTERED Y/ N FEE'CURRE��� 'Y/N � <br /> � <br /> Address ' � , Llcense# � � - <br /> PLUMBER ` ' . COMP.ANY � <br /> SIGNATURE` � REGISTERED Y/.N.� .� FEE CURREN Y/N. <br /> Addre�s License# � <br /> MECHAtdICAL' � ' ' COMPANY, ' <br /> SIGNATURE - � ' REGI$TERED ,Y.,/ N . FEE CURRE� .. Y/N-. <br /> Addres�r � � � '� ' � � - � � - . ~ License# <br /> . . <br /> �� � �. <br /> . �,,.. .; <br /> OTHER : - � � � ',COMPANYf ; <br /> SIGNATURE .'�. "' " ' ` � �' � " REGISTERED' ' Y/ N.... `FEE CURRE� Y/N <br /> Address � �: - ' . - , - - • � License# � , � <br /> .,. : - ,.....< <:... , ,..., .,, .. _..:, ;.;.:::�.< ..<. , . ,,. < � , <br /> ^,�,;:..-: � <br /> RESIDENTIAL;�, Attach(2).,PIof�Plans;(2)sets�-.of:Building7Flans;'(•1)sef of'Energy�Foiin.§;R=O=W Permlt for new construcUon, <br /> ;�-Mfnfmum:ten•(�1,0),worktng;days,aftar:submftfal date.`'Requireil onslte,.Constnicdon-Plans;Stormwater Plans wr%Silt'Fence installed, <br /> �` �"�Sanifary FacillUes:&•1,dumpste,r,_SIte�Work�Permitfor�subdtvisiqns/large.projects;.�._.. .� ' = • <br /> COMMERGIAL Attach(3)complete se�of Builclin'g'Plaris�pius a LIfe�Safety Page;�(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days'after submittal date. Required onsite,ConstrucNon Plans,Stormwater Plans w/Silt Fence installed,- <br /> Sanitary Facilides&1 dumpster_Site Work Pertnit for all new:proJects..All commercial requlrements_must meet compliance ' <br /> SIGN PERMIT Attach"'(2)`sets�ofEngineer.ed%Flans.; .. �• : .. ° <br /> ""PROPERTY SURbEY required for all NEW constructlon., _ � <br /> Direatlon�: -� .� � �� <br /> Ftll out applicaUon wmpletely. <br /> Owner 8 Contractar slgn back of appltcaUon,notarized '• <br /> If over a�500.a Notic�of Commencement ls requlred. (AIC upgrades over 57500) <br /> .. ,�,_.: ' <br /> Agent(for tFie contractor)or Power ofAttomey"(for�Uie owner)would be someone with notarized letter from owner authorizing same <br /> �VER THE COUNTER.PERMITTING --(Front of-Application Only) � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIof/Survey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..need's ROW <br /> � <br />