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813-78M20 City of Zephyrhills Permit Application Fax-813a8"021 a� <br /> Building Department <br /> Date Received Phone Contact for Permitting 1( - <br /> [tlIHEHE "� `! H[tH! <br /> Owners Name 1 V Y \ W �r ` Owner Phone Number Lip .1 O <br /> Owner's Addressf5ls Owner Phone Number <br /> Fee Simple Titleholder Name F Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3�O tt lV LOT# <br /> SUBDIVISION 1 PARCEL ID# S Z, + g <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK 0 FRAME = STEEL v,= <br /> DESCRIPTION OF WORK ¢ exit¢i S1Jr -k-b ^ T V. KO c E <br /> BUILDING SIZE SO FOOTAGE HEIGHT <br /> =BUILDING $ 1-1' ` VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ �l AMP SERVICE Q PROGRESS ENERGY a W.R.I-C. <br /> =PLUMBING $ � � L <br /> =MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING Q SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATION$ FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y I N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N I FEE CURREN <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED YIN FEE CURREN Y/N <br /> Address A License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/N I FEE CURREN i Y/N <br /> Address t n/ License# 13 l—C� <br /> [[H![H[[ JAX (2) <br /> H!!! [[[[! E[[HE![[E!![H[[[[[[H[[[[H[ t[![![[!!ft[t �[[H[J <br /> RESIDENTIAL 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,Storr owater 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.AU 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 /> Rercofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Dfireways-Not over Counter if on public roadways..needs ROW <br />