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813-780-0020 City of Zephyrhills Permit Application- 21 <br /> Building Department <br /> Date Received !�W Phone Contact for Permitting - <br /> 111 . 815611151111 <br /> Owner's Name Q L Z�I A Owne one Number 'IS3^ <br /> Owner's Address 4t D rd (�"1 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address ' <br /> JOB ADDRESS S"0 r S TZ LOT# <br /> SUBDIVISION PARCEL ID# —O —00 <br /> ,,....,,,((())) (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRe ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION BLOCK = FRAME /= SIT <br /> DESCRIPTION OF WORK ZSbg,it Qt'�C�` <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> ILDING $ 1 VALUATION OF TOTAL CONSTRUCTION lY✓ <br /> =ELECTRICAL $ l AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ f � <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION f c <br /> 4 L <br /> =GAS = ROOFING = SPECIALTY = OTHER <br /> S <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA AYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREn I Y/N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREA Y/N <br /> Address I License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N FEE CURREN <br /> Address y License# <br /> I OTHER I CA COMPANY ` R'DiFU J <br /> SIGNATURE dO REGISTERED Y/ N FEE CURREh Y/N <br /> Address 1 (� License# I Ccc 13 ,7Z9 <br /> Illtllllllllltllllllllllllllllllltllllltlltllltllltlltlllltllllllll <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,Stornwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster,Site Work Permit for subdivisionsAarge 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 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 (copy of contract required) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PloUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />