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� s�3-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 1 <br /> 4� Building Department <br /> : , <br /> Date Received �i <br /> Phone'Contact for Permitting -- <br /> Owner's Idame ��'�'''� r ���'�"✓�-� �i�/� 4.� Owner Phone Number 3�°-`�t�'` �L�� I <br /> Owner's Address J ���� ��d�` A�`�� e/� � ,0� �/(�Owner Phone Number <br /> Fee Sim le Titleholder Name <br /> p Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOBADDRESS �a ��'� Ef�� . P/�� y LOT# � <br /> SUBDIVISION . � 7.�C�G PARCEL ID# ����""������U-b�4v a '�(�,�G <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED . NEW CONSTR• ADD/ALT 0 SIGN Q � Q DEMOLISH <br />� e INSTALL e REPAIR` <br /> PROPOSED.USE Q SFR Q COMM � OTHER <br /> TYPE'OF CONSTRUCTION Q BLOCK - Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK /° � �'aj�1 � <br /> BUIL`DING SIZE SQ FOOTAGE� HEIGHT. <br /> OBUILDING $ VALUATION°OF`TOTAL CONSTRUCTION <br /> QELECTRICAL $ , AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> QMECHANICAL $ �j'�.�s.�.+ VALUATION OF MECHANICAC INSTALLATION � <br /> ! <br />', QGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO . ' <br /> �BUILDER COMPANY <br />' SIGNATURE REGISTERED Y/ N FEE CURRE� 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 � COMPANY ��"�� �i <br /> SIGNATURE � REGISTERED Y/ N ,FEE CURRE� Y%N <br /> ' AddFess � �� � Sl7r '��¢� 3'3S�C� License.# � C� E3� <br /> _ OTHER " COMPANY <br /> SIGNATURE.:_ _ REGISTeRe� Y/ N FEE CURREK Y/N <br /> Address,4 � License# <br /> RESID,ENTIAL� Attach(2)Plot Rlans;(2)�sefs of'Building Plans;(1)set of Energy Forms;R-O-W Permit for new.construction, <br /> , ,, _� Minimum-ten:(,10)working;days aftecsubmittal date. Required onsite,Construction Plans,,Stormuvater Plans wl Silt Fence installed, <br /> Sanita.ry.Facilities:&_:1=.dumpster,Site Work Permit for subdivisions/large projects , <br /> COMBAERCIAL Attach�(2)complete sets of Building'Plans�plus a Life Safety.Page;(1)set of Energy Forms.R=0-W Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8�1 dumpster.Site Work Permit fo�all new projects.All commercial requirements must meet compliance II <br /> SIGN PERMIT Attach(2)sets of:Engineered Plans. . <br /> "**PROPERTY SURVEY required foc aII.NEW construction. <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$7500) <br /> " Agent(for'fhe contractor)�or Power of Attomey(for tfie owner)would be someone with notarized letter from owner authorizing same , <br /> � OVER THE COUNTER:PERIIAITTING (copy of contract�required) <br /> Reroofs lf shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Drlveways-Not over Caunter if on public roadways.:needs ROW .� <br />