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/cr-r " v <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> .r. Date Received ff <br /> Phone Contact for Permitting <br /> Owner's Name �y�l'I%�/r�L � / Owner Phone Number <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder AddrreessQ <br /> JOB ADDRESS �!O �7- �gLOT <br /> # <br /> SUBDIVISION t% U P l PARCEL ID# ��L '���Ul�'Q�✓OG`0�?� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN = DEMOLISH <br /> B INSTALL B REPAIR <br /> PROPOSED USE = SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME = STEEL <br /> DESCRIPTION OF WORK IOU .T� J� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $"7-1� VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION r <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO ® �' <br /> ' <br /> � .NY !. . <br /> BUILDER ®• '` `]CO -0 • <br /> SIGNATURE (((///��` REGISTERED/ Y/ N FEE CURREN Y/N <br /> Address 04430L ; —OM1'� License# OLPlC��C <br /> ELECTRICIAN COMPANY <br /> SIGNATURE F REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <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 I Y/N <br /> Address License# <br /> IIIIIIIIIIIIIIIIIIIIt111111111111111tI1111I11111111111111I11t111111 <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 onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)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 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 /> '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 (Front of Application Only) <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 />