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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 2-3 q <br /> e fr Permitting. A . E 0 0 1$ 11 111 go's IIiIIII I <br /> Owner's Name a Cl rr a A/r/wers Owner Phone Number V-2 <br /> Owner's AddressF_,;;7s-;z raoe-lmj-o o, Owner Phone Number <br /> Fee Simple Titleholder Name I Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS', LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT SIGN DEMOLISH <br /> e INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION, BLOCK [0 FRAME STEEL E2r <br /> DESCRIPTION OF WORK &OAk l,-VC? A Aje-V 10401!yg )12ck <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> ... . . . . . . . . . . . . . . <br /> I VIBUILDING 11 , 0 0 Q i VALUATION OF TOTAL CONSTRUCTION <br /> =ELECTRICAL 1$ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> ='PLUMBING $ /Aff P <br /> ja r, e <br /> "Af=MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Zgz I <br /> =GAS Q ROOFING SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES NO <br /> 0 <br /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> I LA <br /> BUILDER COMPANY <br /> SIGNATURE 4 1 <br /> REGISTERED 1(-91 N _J FEE CUR h _J <br /> Address 4,16 1 V;5 License# Fc*'7 c Ts- <br /> ELECTRICIAN COMPANY <br /> ,SIGNATURE REGISTERED Y/ N FEE CURREN <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N I FEE CURREN LYLN_j <br /> Address License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREN Ly LN J <br /> Address F_ 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 clumpster,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 /> . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign b-a-ck"of*cl"'ppji66U6h,-6otadied <br /> If over$2500,a Notice of.Commencement' 1s,requIr� '"d.:-(A1C upgrades over$7500) <br /> Agent(for the contractor)or'P6Wbiof Attorney prl would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING of,contract'requirid) <br /> Reroofs if shingles SeWbm­�--?ServIW:U0grdd6e AIC' "Feinces(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />