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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 �#— / 0 d <br /> Building Department ,ZA/V 9 IS <br /> Date Received Phone Contact for Permitting ) <br /> a[[[[[[[ +'� 19aa[ <br /> Owner's Name V WW p `�c Owner Phone Number Q <br /> Owner's Address 1agS tq(10h hoc h GYlG9 l NE Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESSJ''nn ��LOT## � <br /> SUBDIVISION I��J PARCEL ID# I�aQl a I Do 0~OW CO 0020 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED a NEW CONSTR e ADD/ALT = SIGN = = DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR = COMM = OTHER <br /> TYPE OF CONSTRUCTION = BLOCK = FRAME = STEEL = <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> CL CC i WC CCC C CZ CCC CCC CCC4 C K t CCCCCCCCCIE CCC E CC CC CCCC4 CCCCCC CC i W WIL X CCC C4I <br /> =BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL $ AMP SERVICE = PROGRESS ENERGY = W.R.E.C. <br /> =PLUMBING $ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> =GAS = ROOFING = SPECIALTY = OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address I License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE F REGISTERED Y/N FEE CURREN Y/N <br /> Address I License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/N FEE CURREN Y/N <br /> Address License# <br /> MECHANICAL COMPANYxch r ' <br /> SIGNATURE CC�C r` REGISTERED Y/N FEE CURREN Y1/N <br /> Address 6kA License# ` <br /> OTHER COMPANY <br /> SIGNATURE r REGISTERED Y/N 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 Farms.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 /> _ rrri---——————->ra 4z-i-t4z'ri�r <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(PlottSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..neads ROW <br />