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8�3-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Recelved 2�Z!�+�� phone Contact for Permitting ��-7 SS6 - �663 <br /> � � � 1 � � � � 1 1 1 1 1 <br /> Owner's Name /'{�11 C/I� w�'7s Cfi Owner Phone Number �13- 71 S -'�y'o3 <br /> Owner's Address �I ` 0� w 1 S�(�f 1� p r• Owner Phone Nurtiber <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titieholder Address <br /> � JOB ADDRESS � 7� 3 W)S�'Pr)'� �/' LOT# Z � <br /> SUBDIVISION W�+�S e�;n o kS PARCEL ID# )S' 2 6� �� -01 6 0 -00000 -0 21 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW cON57R B ADD/ALT 0 SIGN � 0 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL � <br /> DESCRIPTION OF WORK /t� � /-� Qr � � shi n / O <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � <br /> �BUILDING $ �� � VALUATION OF TOTAL CONSTRUCTION <br /> I �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ � + ��/ <br /> r; <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '�J �"\ <br /> i v I <br />, OGAS Q ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> I 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 /> 51GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y J N FEE Cl1RRE� Y/N <br /> Address License# <br /> OTHER COMPANY l�` m��B�1 fAI GI OO'-�^� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 7� .3 S�q}Q RO Sy /I�PQ �L 3<<6S3 �icense# GCC .3ZS�33 <br /> Illlllllllllllllllllllllllllltlllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Pertnil for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanilary 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 construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster.Site Work Pertnit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sels of Engineered Plans. <br /> ""PROPERN SURVEY required for all NEW construction. <br /> Directions• � <br /> Fill out application completely. � <br /> Owner&Contractor sign back of appliration,notarized <br /> Ii over$2500,a Notice of Commencement is required. (AIC upgredes over$7500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contrad required) <br /> Reroofs if shingies Sewers Service Upgrades A/C Fences(PIoVSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />\ <br />,� <br />