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atsaeo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> 8uildfng Department <br /> Date Recefved — J �/� phone Contact for Permittln d� �_ � � 9 <br /> Owner's Name �`J � ��/'1 b /� U 4�.. Owner Phone Number �� - // /'��✓� <br /> w.. <br /> Owner's Address �� � a �i S �L Owner Phone Number <br /> Fae Slmple Titleholder Name � ✓� Owner Phona Number <br /> Fea Slmple Titleholder Address +V /� <br /> JOBADDRES5 � PJ� .Q,.�� �"1� I��, �1��' _ LOTt� � <br /> SUBDIVISION W� �LJL I� '2PARCEL ID# � "�lJ��I"O J��'WV4J� 'I� y� <br /> (OBTAINEU FROM PROPERTY TAX NOTIC� <br /> WORKPROPOSED e WSTALL�R� REPAIRT Q SIGN Q Q DEMOLISH <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME Q STEEL Q <br />' DESCRIPTIONOFWORK V �n��[7C��' �i\ � �l.P�� �� ��a(i� �rYi'���7��jt��� <br />, BUILDING SIZE SQ FOOTAGE ���7 HEIGHT � <br /> il <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> �MECHANICAL $`_(��g�j �y VALUATION OF MECHANICAL INSTALLATION <br /> ll.►7 O D + <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE r�clsTeRm Y/ N �cuw�en Y/N <br /> Address Ucense# <br />, PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N �E cuwtEn Y/N <br /> Address License# <br /> MECHANICAL COMPANY � � ��-r �1 �� <br />' SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> li <br /> Address � Y�".�7 �k� �! � License# ��'l� �D � <br /> OTHER COMPANY <br /> SIGNATURE REGIs�REo Y/ N FEE CURREA Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIItlllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plens;(2)sets of Bullding Plans;(1)set of Enargy Forms;R-O-W Pertnit far new consWcUan, <br /> Minlmum ten(10)working days after submittal date. Required onsite,Constructfon Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary Fecilities$1 dumpster;Site Work Pertnit for subdlvistonsAarga praJects <br /> COMMERCIAL Attach(2)complete sets of Building Plans plus a Life Safely Page;(1)set of Energy Forms.R-O-W Pertn(t for new consWcBon. <br /> Minimum ten(10)working days after subm(ttal date. Requfred onsite,Construclfon Plens,Stortnwater Plans w/Sflt Fence fnstalled, <br /> Sanitary Fecilities 8 1 dumpster.Site Work Pertnit far all new projects.All commercial requiraments must meet wmpliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construc[ton. <br /> Dlrections:• <br /> Fill out application completely. <br /> _ Owner&Contractor sign back oF application,notarized <br /> I(over 52500,a Notice of Commencement Is requlred. (A/C upgrades over 57500) <br /> •• Agant(for the conVactar)or Power of Attamey(for the ovmar)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgradas A/C Fences(PIoVSurvey/Faotage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />