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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> I �Date Received Phone Contact for Permitting 0 p <br /> /3 <br /> Owner's Name P dN'1 dl D CQ 6L® Owner Phone Number <br /> Owner's Address .�J�/ &"�' c✓ • 2 l s -33 Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address g® <br /> JOB ADDRESS SJ/� !(O�� f LOT# <br /> SUBDIVISION PARCEL ID# f/-a(o —,Pt^DO1D Iwo— (�1�-� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED R NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK Q FRAME = STEEL = <br /> DESCRIPTION OF WORK /if/S¢��� IX'1&t Q dAVrA S 01/02 S1f1I'V6(.GfS 7HeA✓/U5-TH2L S"1(ACrR <br /> BUILDING SIZE SQ FOOTAGE O® HEIGHT <br /> BUILDING $ Pr1 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ tJ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Y/N <br /> Addressjy- License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE i; REGISTERED Y/ N_J 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 <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN "YIN <br /> Address 34ayG 5oc1 fl► / �lS �Z 33S License# e�C y9 70 <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 ofIBuilding\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)fon public roadways..needs ROW <br />