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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received 6 Phone Contact for Permitting — <br /> Owner's Name o / / / /s Owner Phone Number <br /> Owner's Address I 7CM C72(1 Ny zlphi IJ Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple,Titleholder/Addr`es/s // ) <br /> JOB ADDRESS C97Z LOT# <br /> SUBDIVISION F PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR B ADD/ALT 0 SIGN [t� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION-• - Ot BLOCK Q FRAME = STEEL = <br /> i •, <br /> DESCRIPTION OF WORK /�54a`l DYLQ dkm yl(a� 410M Unlzw ca��i?ec exlS7 Y?011- <br /> i ° <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> 12iUILDING VALUATION OF TOTAL CONSTRUCTION <br /> MELECTRICAL $ 5C) d AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ 1� <br /> =,MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =OAS Q ROOFING Q SPECIALTY OTHER <br /> FINISHED,FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER i �- COMPANY LS�T7 �l rile <br /> SIGNATURE ��/� REGISTERED Y/•N FEE CURREN Y/N <br /> Address L l /r Q�Y ed w m License# <br /> ELECTRICIAN �c4k iPANY =1�0* S1 �YUI <br /> SIGNATURE REGISTERED Y'/ N FEE CURREN Y/N <br /> j <br /> Address L I L C License# TSf Z06 G3 <br /> PLUMBER: COMPANY <br /> SIGNATURE REGISTERED' Y/ N • FEE'CURREN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y./ N FEE CURREN <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE. REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <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;'Stormwatet Plans w/Slit 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 construction. <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 Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN'PERMIT Attach(2)sets of.Eiigineered Plans. <br /> ""PROPERTY,-SURVEY required for all NEW construction. <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. (A/C upgrades over$7500) <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 contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />