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city of Zephyrhills Permit Application Fax B13-780-0021 <br /> Building Department <br /> ,ter N <br /> Date Received <br /> -2,1 Phone Contact for Permitting I t I a a a a I I I <br /> Number Pho <br /> ne one <br /> Owner's Name L <br /> Owner's Addressl Jr owner Phone Number F_ <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> Pf JOB ADDRESS yp I C L. N_ <br /> �A LOT <br /> y <br /> 0/000-Dfeo <br /> SUBDIVISION kj ARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRF7 ADD/ALT SIGN = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE 0 SFR COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK FRAME STEEL <br /> DESCRIPTION OF WORK. <br /> BUILDING SIZE S Q FOOTAGE' HEIGHT <br /> A A A A <br /> =BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL AMP SERVICE = PROGRESS RGY Q W,R,E.C. <br /> =PLUMBING, <br /> =MECHANI'CAL $ VALUATION OF MECHANICAL INSTALLATIO <br /> GAS 7� ROOFING' SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> L <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y <br /> Address y Licenseo F rR C103s,i:� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y1 N FEE CURREN I Y 1114 <br /> Address. S Q6 S:V-, ilA IQ 564A3 Licensei <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEEICURREN -(/N <br /> Address 3I-6 k, S-4-2 10M IRA License#1 C C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y VN FEE CURREN\J <br /> Address 1'5_10' - DxSley- (4- b6z �A L-6_q :34" License# FCA U,33 W 9 <br /> OTHER COMPANY r(l Ia 0— K�6 <br /> SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address W" 3Cy31 License# Is S3 <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&I 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 Per*rrit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsItei Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&I dumpater.Site Work PermItfor all new projects,All commercial requhmenti 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 /> \iroois it shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />