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, <br /> I Fax-813-780-0021 <br /> � . =vi�� $13-780-0020 City of Zephyrhills Permit Application <br /> , , • Building Department <br /> Date Received Phone Contact for Permitting – <br /> -�-�-�-�-�-�-r-�- - - -rmn - <br /> Owner's Name �i1� Owner Phone Number ��� �� r <br /> `7 �. �n ?.3b �`,,�-�"� ! � S l 3 I 7 <br /> Owner's Address d er Phone Number <br /> Fee Simple Titleholder Name ,� VI� d�.�[�(,� Owner Phone Number � <br /> FeeSimpleTitleholderAddress 7(p f( l � � � � � '1��3� <br /> J{}B ADDRESS � If LOT# � <br /> SUBDtVlSIQN � ^� PARGE�!D# <br /> {q6TAINEp FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONS7R 8 ADD/ALT � SlGN Q � QEMCJLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME 0 STEEL � <br /> DESC}2IP7tON OF WORiS �M re, �k e� N('@ AC� c� '�"i <br /> BUILDlNG SIZE 5Q FOQTAGE ��I�� HElGHT o�?�� �� <br /> �BUILDING �� � n � VALUATION OF TC7TA�GC?NSTRUCTION <br /> d� <br /> �ELECTRICAL $ �� �Q� AMP SERVICE � PF20GRESS ENERGY � W.R.E.C. <br /> �PLUMBING ($ - � � � � <br /> � s������� <br /> � _,_._ � <br /> QMECHAN(CRL $ �n ��U VALUATION OF MECHANICAL INSTALLATION � ��� <br /> ..� <br /> �GAS [� R40F(NG 0 SPEC(ALTY � OTHER �/: <br /> FINISHED FLOdR ELEVATIONS �ip � � FLOOD ZONE AREA �YES ( O"J {}�� � <br /> 9 { ' �`"� l.J��� <br /> BUILDER Qv,4, �" ��C�j�`]�COMPANY <br /> SIGNATURE � �� �i��� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— T�� <br /> .. .._...-....,r._. r <br /> ELEC7RICIAN '�(y� , �Q COMPANY <br /> SlGNATURE �"�"�� � REGISTEREO Y I N FEE CURRET Y/N <br /> Address License# �— �� <br /> PLUMBER ����T�y�����(�qt/ ` COMPANY <br /> SIGNATURE f '� f2EGI5TERED Y I N FEE CURRE� Y I N <br /> Addres_ s License# �— � <br /> LuM,��C._ <br /> �'"��� ^/} �OMPANY <br /> SfGNATURE ��-�`- r , REGISTERED Y 1 N FEE cuRREn Y/N " <br /> Address License# �` �� <br /> OTNER � � COMPANY <br /> SIGNATURE j � REGISTERED Y 1 N FEE CURRE� Y 1 N <br /> Address License# � � � <br /> 1tl1111I1It1I1IIiIIIiIiIilililtltlllilltlt1l11IiI11llllillllt111111 <br /> RESIDENTlAL Attach(2)Plat Pfans;{2)sets of Building Plans;{9}set of Energy Forms;R-O-W Permit for new canstruction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence insta!led, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisians/large projects <br /> COMMERCIAL Attach(2)compleie sets of Building Plans plus a Life Safety Page;{1}set of Energy Farms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days after submitta!date. Required onsite,Construction Plarts,Stormwater Plans w!Silt Fence instalfed, <br /> Sanitary Facilities&1 dumpster Site Work Permit for all new prajects.All commercial requirements must meet compliance <br /> StGN PERMlT AiTach{2)sets of Engineered Plans. <br /> ""*"PROPERTY SURVEY required far all NEW cansiruction. <br /> , . . . . . . . . . . . : . . . . . . . . . . . . . . . <br /> Directions:• <br /> Fill out application completely <br /> Owner&Gontractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500} <br /> *` Agent(for the contractor}or Power of Attomey(for the owner}would be someone with notarized letter from owner authorizing same <br /> OVER TNE COiJNTER PERM(TTING {copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrac3es R!C Fences(PIoUSurveylFaotage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />