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6y# 77 704 4 Fax-813-780-0021 <br /> 813-780-0020 City of Zephyrhills Permit Application <br /> Building Department 35 0 <br /> Date Received V. ,RQ . ao a o Phone Contact for Permitting sa <br /> Owner's Name ,A Owner Phone Number 98 o e <br /> wl <br /> Owner's Address Owner Phone Number <br /> Fee Simple Titleholder Name F Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 7? LOT# <br /> SUBDIVISION PARCEL ID# y' oZ S• / 171 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE = SFR 0 COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL Q 1 <br /> DESCRIPTION OF WORK • �7 <br /> BUILDING SIZE SQ FOOTAGE 7 HEIGHT <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY 0 W.R.E.C. <br /> =PLUMBING $ <br /> [MECHANICAL $S VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY_—1_ " <br /> -SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License#, <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 v <br /> SIGNATURE REGISTERED N FEE CURREN N <br /> Address �da2 S til S O License# G�s <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 1en(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 /> 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 authorizing same <br /> OVER THE COUNTER PERMITTING (copy of contract required) <br /> Reroofs if shingles Sewers Service_Upgrades-A/C-- ° Fences(PlottSurvey/Footage) <br /> Driveways-Not over Counter if`on public,roadways..need§.ROW <br />