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a��-�aaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> i <br /> � <br /> Date Received phone Contact tor Permitting <br /> -- <br /> -r-r�-r.-�-r-rr. _ ...-- - - .. ..._ -rr� - - - <br /> Owner's Name �GO�V-7' LC�1Y1� Owner Phone Number <br /> Owner'sAddress �L'��� �r`�1 �`� `�p�1r�►`'�j OwnerPhoneNumber <br /> Fee Simple Titlehalder Name Owner Phone Number " <br /> Fee Slmple Titleholder Address <br /> ,.� �JOB ADDRESS �� ` � Y �� '��, LOT# <br /> r l7ii�{ .. 1y <br /> SUBDIVISION ;s t o vtst2- :i1�s:�paq�@E i�.t ��'�'��1'�� d 11�; C:�"'�:c C�.'u C� <br /> ��ti?,gE�� �no�2z�inmc;l .��• q(OBT�IINEDFROMPROPERTYTA7CNOTIC� <br /> WORK PROPOSED ns,��lE�C44�7[� �,r i� rAmol6uyi'd '•,,'.�u;,51G Q Q DEMOLISH <br /> 1NSTALL � RE�P�AI�R � ��� <br /> PROPOSED USE COMM Q OTHER �� <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q \ <br /> DESCRIPTIONOFWORK S`Zt-'' "�'�r ��Z� ��. C��L:tii^ �L' C�t/L� � 6'�I'�'� <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � <br /> QMECHANICAL $ .� VALUATIONOFMECHANICALINSTALLATION '�/���/ l�..._J �Q� � <br /> �5�� r „���. �A,,,Q P.� <br /> OGAS Q ROOFING Q SPECIALTY � OTHER � ��� ��JU <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <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/ N FEE CURRE� Y/N <br /> Address :� License# <br /> MECHANICAL ./� '� i COMPANY �Y�Y1C� � ���-� ��`���' i � <br /> SIGNATURE REGISTERED Y/ N FEE CURREI. Y/N <br /> Address �'��� � �;^ ,_'v` License# ����1�� �` <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItllllllllllllllltllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnit for new construction, I <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w!Silt Fence installed, I <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets af Building Pians plus a Life Safety Page;(1)set of Energy Fortns.R-O-W Permit for new consWction. , <br /> Minimum ten(10)working days after submittal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster.Site Work Permit for ali new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW consWclion. <br /> ' liiifil { fl { Ilf � llll Y • ' LiLi � llllll ' <br /> Directions: <br /> Fill out application completely. ' <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement Is required. (A/C upgrades over S7500) <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 if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) �I <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />