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City of Zephyrhills Permit Application Fax-813-780-0021 <br /> ',Building Department <br /> um <br /> Date Received 1510 e-CAUCa i(V,-0 CA k+ortm C4 <br /> Phone Contact for Permitting F(a <br /> Owner's Name <br /> Owner Phone Number <br /> �6rkm linc <br /> Owner's Address v M- p 33(J f Owner Phone Number <br /> ber <br /> 'Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS \f0S+-J2y- 3 LOT# III/IA <br /> SUBDIVISION 'PARC' El <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR F7 AD D/ALT SIGN DEMOLISH <br /> E5 INSTALL REPAIR <br /> PROPOSED USE SFR = COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME STEEL <br /> DESCRIPTION OF WORK Stmlp_ �dwdq resiAnc-c- <br /> \J ' _1J <br /> BUILDING SIZE SQ FOOTAGE a 3 S3 ar(f HEIGHT <br /> r . . . . . . . . . . . . . . . .. . <br /> BUILDING VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL 1$ AMP SERVICE 0 PROGRESS ENERGY W.R.E.C. <br /> t <br /> =PLUMBING $ <br /> =MECHANICAL 1$ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS ROOFING SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS DD-- <br /> FLOOD ZONE AREA =YES- NO <br /> BUILDER COMPANY <br /> SIGNATUREddd.���"' REGISTERED Y/ N I FErz CURRER L_Z LN _J <br /> Address )t com :D a hn p License# <br /> ELECTRICIAN 0, > COMPANY Esim Ar4 Eledy—i- c <br /> SIGNATURE L-� . I' REGISTERED I Y/ N FEE-CORREN I Y7N <br /> Address 16.., Z"j., J' 03 License# I Ec � 0 --4- � <br /> PLUMBER COMPANY Uk-_ <br /> SIGNATURE REGISTERED Y/ N - 'FEE CU_RRdN LLY1 N <br /> Address bi-b- Bbv 330)7- <br /> 2Z13 T4 License# FCc_6(4 <br /> I Na <br /> MECHANICAL COMPANY <br /> SIGNATURE E REGISTERED FEE CURREN Y/N _J <br /> Address 5_q 0 Ct NJ e W I o License# I (A co 33 �� 5 <br /> OTHER COMPANY 04crtmld 2064 <br /> SIGNATURE REGISTERED FEE CURREN I Y/N 5§_ <br /> Address \3 License# 1E :1 S 2 5-3 3-3 <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 Atfach'(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 /> - - - - - - - - - - - - - <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. (AIC upgrades over$7500) <br /> Agent(for the contractor)or Power of Attorney(for the owner)would be someone With notarized letter from owner authorize, Kg'.§pmp <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 />