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C813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department � Q <br /> Date Received � G��LJ t� <br /> Phone Contact for Permitting /Q <br /> -nTrrrrr rr-1-r -- / <br /> owners Name 5 ra n Q <br /> // Q Q Qa' Owner Phone Number v'3- 5- 7�rO <br /> Owner's Address -3 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address �1- 1 <br /> JOB ADDRESS l�I3 3 !/ 'R S5 _ hyA4 1S 33s&ia LOT# <br /> SUBDIVISION PARCEL ID#I 0-�I-,�2l9 A)-OI30^QQo©o-do8a <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN 0 Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL = <br /> DESCRIPTION OF WORK � W t n V ouiS S�Z R_ �-oC- <br /> BUILDING SIZE SO FOOTAGE= HEIGHT <br /> -rrrrrrrrrrrrrr-rr-r-r'r'rrrrrrr-rrr-rr-r+-rr rrrrrrrrm-r-r rt-rr'rr <br /> BUILDING $,2q CO m VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ J AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> . . . . . . . . . . .-:,-. . .... . ... . . . . . . . .. ... . . .. . <br /> BUILDER F �/ COMPANY WQ CatT WJ`1ek1l S <br /> SIGNATURE /I REGISTERED Y/ N FEE CURREN Y/N <br /> Address O'OP TRIM eff4e---J.{ y>, k " 3 3-7 License# L C S 5 y&A <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN LILN <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address I License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Address License# <br /> Iltlllllllllllllllllllllllllllllllllllllllllllillllllllllllllllllll <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 dale. Required onsile,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 construction. <br /> Minimum ten(10)working days after submittal dale. Required onsile,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpsler.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 /> 1..1..1...E-• <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 />