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atsasaoozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ' ' Building DepaAmenl <br /> Date Received phone Contactfor Permlpin <br /> Ownels Name Owner Phone Number <br /> Ownels Address Owner Phone Number ,�- <br /> Fee Simple Titlehotder Name Owner Phone Number <br /> Fee Slmple Titleholder Address <br /> JOBADDRESS LOT� � <br /> SUBDIVISION PARCEL ID/F <br /> (OBTAINED FROM PROPERTY TA%NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL 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 ' <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> QBUILDING § VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL S AMP SERVICE Q PROGRESS ENERGY Q W.RE.C. <br /> QPLUMBING 5 <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALN Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> -- i i i0 �i iii i' { G �ii i iii�-1 �F-i <br /> BUILDER COMPANI' <br /> SIGNATURE REGISTERFD Y/ N FEE CURRFJ� Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREA Y!N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED -Y/N �e cuwten Y/N <br /> Address License 1l <br /> A, - <br /> MECHANICAL COMPANY P�►��us��.,��qc�,vre�����.{�, <br /> SIGNATURE REGISTERED Y/N �cuw�n Y/N <br /> Address � ( �jflv�� � 1� �� License# �l-�C-o a37� <br /> O7HER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREA Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIII1111111111111111141IIIIIIIIIIIIIIIIIIIIIIIIIt111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns,R-O-W Permit for new consWction, <br /> Minimum ten(10)working days after submiltal date. Required onsite,ConsWclion Plans.Stortrnvater Plans w/Silt Fence Installed, <br /> Sanitary Facilities&1 dumpster,Sile Woric Pertnit for subdivisions/large projeGs <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Li(e Safety Page;(1)sel of Energy Forms.R-0-W Pertnit for new oonsWdion. <br /> Minimum"ten(10)vrorking deys after submittal date. Required onsite,ConsWction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Fadlittes 81 dumpster.Slte Work Pertni[for all new projects.All commercial requlremenls must meet compliance <br /> SIGN PERMIT Attach{2)sets of Engineered Plans, <br /> ""PROPERTY SURVEY required for aIl NEW cansWctian, <br /> - - - - L. <br /> Directions: <br /> Fill aut appliraGon completely. <br /> Owner&Contraclor sign back of applicatlon,notarized <br /> If over$250D,a Nofice of Commencement(s requlred. (AIC upgrades over E750D) <br /> " Agent(for the contractar)br Power of Attomey(forthe ovmer)would be someone wlth noladzed letler from owrier authorizing same <br /> OVER THE COUNTER PERMITTING (copy of canVact required) <br /> Rernofs if shingies Sewers Service Upgrades NC Fences(PbVSurvey/Foolage) <br /> Driveways-Not over Counter If an public roadways..needs ROW <br /> I <br /> L I <br />