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\ <br /> � , 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> 8uilding DepaAmenl <br /> Date Received ��v �G phone Contact for Permlttln ��v Tl0/ — �� �' <br /> .'�__�_7_�_ _ __ -" _'I�IT <br /> Owner's Name � � Owner Phone Number � S � <br /> Owner's Address `l5J� Q � \�(Gu'Ck'\ �l/'r' �-1� Owner Phone Number <br /> Fee Slmple Titleholder Name Owner Phone Number <br /> Fee Slmple Titleholder Address <br /> JOBADDRESS � �2 �x.i 1 1 i , "F��� I � LOT# � <br /> SUBDNISION PARCEL IDl� �`1�Z�9�`I O` 1 O����` (�Z 1 Q <br /> (OBTAINEO FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW cONSTR ADD/ALT 0 SIGN Q Q DEMOLISH <br /> 8 INSTALL B REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK • O �l,W�Q�I S1�1�-Y S S�� � C7 M�v��" <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> BUILDING $z� ,�,(� VALUATION OF TOTAL CONSTRUCTION <br /> v w� <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY 0 W.R.E.C. <br /> �PLUMBING $ � �v V <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � 1` � l� <br /> � � ��� � / <br /> QGAS Q ROOFING Q SPECIALTY � OTHER � /� �� v <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO � �"� <br /> � <br /> l <br /> BUILDER • OMPANY• • A,r�v� •I� •�hS�� • <br /> SIGNATURE REGISTERED N FEE CURRE� Y/N <br /> Address Z(p Z,Z1 �l i' � V,Un � License# C-�5` ��� J <br /> ELECTRICIAN � r/ �9 �COMPANY e�S� �'��`L�K �C_• <br /> SIGNATURE ��`� REGISTERED N FEE CURREA N II <br /> Address Q� ��� ��1 {h�{�b �� 'D�(ti� License# ���( 3 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED YI N FEECURRE� Y!N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE cuwtEn Y!N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEECURRE� Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIl11i91111111111111111111111111t11111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)sat of Energy Forms;R-O-W Permit for new construcllon, <br /> Minimum len(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities�1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construciion. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster.Site Woric Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW conslruction. <br /> Directions:• <br /> Fill out application completely. <br /> Owner&Contractor sign back of applica[ion,notarized <br /> If ovar$2500,a Notice of Commencement fs required. (A/C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of conVact required) <br /> Reroofs If shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />