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513-780-0020 City of Zephyrhills Permit Application Fax su 78°°°21 <br /> Building Department n TT <br /> r — Q ..� <br /> Sate Received Phone Contact for PennMn <br /> Owners Name Owner Phone Number <br /> owners Address <br /> Ica e. V barn P&t t.. <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address T y� ` <br /> JOB ADDRESS Old O91 !�� 1 1 l +1 S LOT It <br /> SUBDIVISION PARCELIDB O�-�� o6I- -taDOO-Doll <br /> (OBTAMM FROM PROPOMTAY HUnCE) <br /> WORK PROPOSED a NEW CONSTR 8 ADD/ALT Q SIGN Q Q DEMOuSH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Qnn r�BLOCK Q FRAME Q STEEL = <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SO FOOTAGE® HEIGHT <br /> =BUILDING s 1—y s 1 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL s 1 1 oG, AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING s <br /> =MECHANICAL Is..,e, VALUATION OF MECHANICAL INSTALLATION=GAS --Hf—t ROOFING Q SPEGALTY Q OTHER 8 /,/, <br /> �f <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REMST RED I YIN FEE CURREt Y I N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURDK Y/N. <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURit£T. LILN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/N FEE CURREN Ly/N <br /> Address A <br /> License# L <br /> OTHER COMPANY <br /> SIGNATURE RECUST�RED I YIN FEE CtmREr //--Y/N <br /> Address � QX M%(� � �' L;cer�e# C Cl. �0- <br /> 1111111111111111111111111111111111111011111111.IIIIIIIIIIIIIt1111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bulkling Plans;(1)set of Energy Forms;R-PW Permit for new constrttction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/SM Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsllarge projects - <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Fors R-C-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Require m <br /> d onsite,Construction Plans,Stornwater Plans w/Solt Fence installed, <br /> Sanitary Faolities&1 dumpster.Site Work Permit for an 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 /> Fig out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> �1 If over S2500,a Notice of Commencement encemertt 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 auttwrmng 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 i/on public roadways..needs ROW <br />