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813-780-0020 City of Zephyrhills Permit Application Fax 813-780-0021 <br /> Building Department <br /> 4' <br /> Date Received Phone Contact for Permitting QQ <br /> Owner's Name G' I Owner Phone Number <br /> Owner's Address 320(, fil®t.IJ-m 4a 1©w Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address .3-3 D 04ow1de O Ow <br /> JOB ADDRESS F LOT# <br /> SUBDIVISION PARCEL ID# 1 100-00000 '®95-11 <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 Q BLOCK ) /0 FRAME = STEEL = <br /> DESCRIPTION OF WORK 6 )191-taace 200 <br /> BUILDING SIZE 1.4�00TAGE,2 � HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ . AMP SERVICE = PROGRESS ENERGY Q W.R.E.C. <br /> =PLUMBING $ (jam <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �//1 L <br /> =GAS = ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY C' G "If t <br /> SIGNATURE 1� REGISTERED Y/ N FEE CURREN Y/N <br /> Address �/ ST'� `v License# l 11 .S <br /> ELECTRICIAN COMPANY <br /> SIGNATURE 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 LYLLN <br /> Address: License# <br /> OTHER COMPANY <br /> SIGNATURE ! REGISTERED Y/ N_J FEE CURREN Y/N <br /> Address License# <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 /> 44 <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 />