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I <br /> 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting — <br /> Owner's Name tN C Owner Phone Number <br /> Owner's Address �� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address L/ rr� <br /> JOB ADDRESS / A (� LOT# <br /> SUBDIVISION Uv�DO L(OD� PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION 0/ BLOCK /= FRAME = STEEL = <br /> DESCRIPTION OF WORK ©D� U t,1 3� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ I/V AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION 1/ <br /> =GAS [[]� ROOFING = SPECIALTY = OTHER (� i <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED r Y/ N FEE CURREN Y/N <br /> Address License# <br /> ELECTRICIAN COMPANY <br /> SIGNATUR9 REGISTERED Y/ N FEE CURREN Y/N <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 Y/N <br /> Address License# <br /> OTHER C/ _ COMPANY �' okJ <br /> SIGNATURE REGISTERED Y/ N _J FEE CURREN Y/N '/ <br /> Address a J�3 License# �� 4t Y <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,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 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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />