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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting <br /> ....... .......... . .........Owner's Name U Y)OTQ Owner Phone Number <br /> Owner's Addressl 7 YZ Z4\ S Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address F <br /> JOB ADDRESS LJ-7 LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROMPROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTRR ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE = SFR Q Comm OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK = FRAME = STEEL <br /> DESCRIPTION OF WORK UJ'I ` t czv 0� <br /> BUILDING SIZE 7VSQ FOOTAGE� HEIGHT <br /> =BUILDING qg 76 VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C, . <br /> =PLUMBING 1$ Q) <br /> 771 <br /> =MECHANICAL $ I VALUATION OF MECHANICAL INSTALLATION <br /> =GAS Q ROOFING 0 SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS 7 .FLOOD ZONE AREA =YES NO, <br /> i I i l 1 1 1 1 1 i 1 1 Nil a 1 1 <br /> BUILDER COMPANY A(;JyrL--01—. <br /> SIGNATURE REGISTERED Y/ N�j CURREN L Y 77 <br /> 1 1 /N J <br /> 0E <br /> Address S License# <br /> ELECT REGISTERED -YJ N., I <br /> ELECTRICIAN COMPANY <br /> SIGNATURE FEE CURREN 1_t!N J <br /> Address Lfcense# F— <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/,N, FEE CURREN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y N- FEE CURREN L )LLN J <br /> Address -License# <br /> J <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED N FEE CURREN <br /> Address License# <br /> "ft 111111 11 ii I I I I I I H!!1111 H 1 Ff 11!1111!111 1H!11111 1 j-1*-HHH I I I i's I I I I I I I I I I I I I I I <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,(l 0)working days after submittal date. 'Required onsite,Construction Plans,Stormwater Plans wl Silt Fence installed, <br /> Sanitary Facilities&I dumpster,Site Work Permit for subdivisions/largd 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&I 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 /> . .......... .................. ....issa SlIallaggal ails W <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. (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 Sbwers Service Upgrades A/C Fences(Plot(Survey/Footage) <br /> Drivewayi-Not over Counter If on public roadways..needs ROW <br />