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� <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780.0021 ! <br /> Building Department � <br /> Date Received phone Contort for Permftting I <br /> -rrr'r1�- rr , <br /> Owners Name Owne�Phone Number '� 1 I <br /> Owners Address O Owner Phone Number I <br /> Fee Slmplo Titleholder Name � Owner Phone Number <br /> Foo SlRtple TiUeholder Address <br /> JOB ADDRESS LOT# � <br /> SUBDIVISIQN FARC�L fD# <br /> (98TAINED FROM PROPtRTY TAX NOTICE) � <br /> WORK PROPQ�ED � New coNSrR� ADplALfi [� SIGN Q Q D�MOUSH <br /> INSTAIL REpAIR <br /> PROPOSEO USE � SFR Q C4MM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK [] FRAME � STEEL Q <br /> DESCWPTION OF WORK �� <br /> BUI4DING SIZE �� SQ FOOTAGE� HEIGHT <br /> • �.'r'T'�'�"r"r�- <br /> �BUILDING $ VALUATION OF TQTAI CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PR06RESS ENERGY Q W.R.E.C. <br /> QPLU�v1BING $ <br /> �MECHANICAL $ VALUATION OF MEChIANICAL INSTALLATION �( / �/�v <br /> � � C <br /> QGAS Q ROOFING � SPECIALTY �� OTHER <br /> FINISHED FLOOR ELEVATIONS F�.00D ZONE ARCA QYES NO <br /> 1 L i 7 1 k.' 9 4 g 7�9.S : i S i 1 d R � 8�"ri.2 i.S-i .�-.--.�,.-.'�7.�C-�-.D-6�bi:.,- <br /> BUILDER � � COMPANY <br /> SIGNATURE RHGISTERED Y/ N FEE CURRE4 Y/N ' <br /> Addresa I License# <br /> ELECTRICIAN � COfWPANY <br /> SIGNATURE � RC-GIS7ERED Y( N F�E CURREA Y/N <br /> Address License it � <br /> PLUMBER � COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address LicenSe# <br /> MECHANICAL COMPANY �� �/I�I <br /> SIGNATUR[ REGIBTEREO Y/ N FeE cuRRen Y/N <br /> Address Li�ense� <br /> OTHER COPdRANY <br /> SIGNATURF REGISTERHD Y/ N FEE CURREA Y/N <br /> Addross License# <br /> OIIIIIIIii11i7E01l1161flllllil011111111111llltilllll111111111191911 <br /> RESI�ENTIAL Attach(2)Plot Plans;(2)sets of 6uildin�Plans;(1)s,et of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)wor'King d�ys after submittal date. Fe9uired onsite,Constructfon Plans,Stormwater Plans wl$ilt Fence installed, <br /> Sanitary Facilities$1 dumpsto�;Site Work Permil fo�subdiNsionsllarge projects <br /> COMMERCIAL At:ach(2)complate sets of Buiiding F�lans plus a Life 3afoty Page;(1)set of Energy Form�.R-O•W Permit far new construdion. <br /> Minimum te�(10)v,rorking days after submittal date, Requi�ed onsfte,Construction Plans,Stormwater Plans�v/Silt Fence installed, <br /> Sapitary F�cilities&1 dumpster Site Work PeRnit fqr ali new proJects.All qommercial requirements must meet compllance <br /> �IGN PERMIT Attach(2)sets of Engineered Pians. <br /> ""PROPERTY SURVEY required for all NE�N co�strudion. <br /> �. . . . - '.' . i.5:�-..-a-�,�...� <br /> Directions:• <br /> Fill out opplicatlon completely, <br /> Ovmer 8 Cqntractor sic�n bacic of appiica5on,notarized <br /> If over$2500,a Notice of Comme�cement is requfred. (AlC upgrades over�7500) <br /> " Agent(for the contractor)or Power o�Attorney(for the qvmer)would be comeone wlih notarized letter irom owner�uthorizinp sarpe <br /> OVER THE COUNTER f'EF�MI'iT�NG (copy of contract requlred) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoU$urv�ylFootage) <br /> DrivewaysNot over Counter if on pubiic roodways..needs ROW <br />