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Pam <br /> J <br /> a13-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received I Phone Contact for Permuting f� <br /> -y-i--1-f-;-1- rr-rrr-r.-rr-s-rRRRRR���T���TTrr-rr-r t-t-i _ �.. ^v�� <br /> Owner's Name 7 <br /> Owner phone Number —I <br /> Owner's Address + —T Owner Phone Number I1 <br /> Fee Simple Titleholder Name ( Owner Phone Number I <br /> Fee Simple Titleholder Address ( (. <br /> s <br /> JOB ADDRESS I�—^t4 ..(r—.�L' A P h f h I S i LOT# <br /> OD <br /> SUBDIVISION l PARCEL IDq <br /> (OBTAINED FROM PROPERTY TAX NOTICE) - <br /> WORK PROPOSED e NEW CONSTR 8 ADDIALT l� SIGN Q 0 .DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR Q COMM CJ OTHER <br /> TYPE OF CONSTRUCTION 0 BLOCK <br /> j 0 FRAME STEEL Q <br /> DESCRIPTION OF WORK 7U4�(�J1 <br /> BUILDING SIZE SQ FOOTAGE HE t � <br /> TITf�I`T"ITT�1'T"1:•Tt�fTr'7Tr'T'ITT'1'7'r'iT.'PTT^ - . .. .. _ 1�.'�r'!'l�tTl'T`!•' <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL ($ �. AMP SERVICE Q PROGRESS ENERGY = W.R.E.C. <br /> =PLUM6ING <br /> �(IMECHANiCAL VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING = SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE i REGISTERED I Y/ N FEE CURREt. I Y!N <br /> Address License# <br /> ELECTRICIAN. COMPANY <br /> SIGNATURE t REGISTERED � FEE CURREt Y/N <br /> Address license#r <br /> PLUMBER COMPANY. <br /> SIGNATURE REGISTERED Yt / N FEECURRE! LXLN. <br /> Address License# F_ ' <br /> MECHANICAL COMPANY r� /�( �I 5erVj�G S dT Pa,5c.O <br /> SIGNATURE 7 ) // ?REEGIISST,ERRED Y/'N FEE CURREN I �+Y�I N p.p <br /> Address kag <br /> Cz !hr`!�SJ��?/1. <br /> License#MIS <br /> OTHER, COMPANY <br /> SIGNATURE I Y"/ N ' FEE CURREI, <br /> Address License# <br /> { { flllttt,tl'! { { 11Illllt'I { { Ili { IIiIIII { ittltLt { 111111111111'111111'1111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortes;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 Fac- <br /> -Miles&1 dumpster;Site Work.Permit for subdivisionsharge 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,Storrnwater 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 /> ;TrT i1- <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. (AfC 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 />