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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received 3 Phone Contact for Permitting �qj <br /> Owners Name U a I au Owner Phone <br /> Owner's Address 7 1 &ech 5+ Vl f h 111 ,5 Owner Phone Number <br /> Fee Simple Titleholder Name owner Phone Number <br /> .Fee Simple Titleholder'Address <br /> JOB ADDRESS ZCok,[( 635q a LOT <br /> SUBDIVISION 0,d6('\466'1 PARCEL ID# _'IbW ~bL&C) WOO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN F 0VE DEMOLISH <br /> R . INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOFK FRAME Q STEEL Q OTHER I <br /> DESCRIPTION OF,WORK. to 6,5! lO H (T M be(fAt ZP66,11 3hi 03)ei 510 U-& <br /> 7—] 1 e_7 <br /> BUILDING SIZE SQ,FOOTAGE HEiGHT <br /> .......... <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C, <br /> PLUMBING $ <br /> (906 <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> - GAS Q ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS- FLOOD ZONE AREA r___1YES ONO <br /> 2 6 N N N o 6 a N 1 i N 2 <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT YIN <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N _J FEE CURRENT LILN_J <br /> Address License F <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT <br /> Address F_ License# F_ <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Ly/N <br /> Address License# <br /> OTHER'- . COMPANY -Toc <br /> SIGNATURE REGISTERED N I FEE CURFItNT <br /> LC�C �13 3 55 65 <br /> Address q 13 37P 5q-�' �.License# <br /> �M <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(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 FacillUes.&I dumpster,Site Work Permit for subdivisions/large projects <br /> COMMERCIAL. Attach(3)sets of-Building Plans;(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,St6rmwater Plan S. w/Silt Feriab installed, <br /> Sanitary Facilities&I dumpster.Site Work 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 construction. <br /> ............... .............331=1.................................... .......... ....... <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. (AIC upgrades over$5000) <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 (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> ;Driveways-Not,ov6r Counter If on public roadways..needs ROW <br />