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813 -780 -0020 City of Zephyrhills Permit Application Fax- 813 -780 -0021 <br /> Building Department <br /> Date Receivd"a CJ j)�t <br /> / a <br /> � Phone Contact for Permitting -- <br /> Owner's Name A /Aiez. ?.0 j 1 f (./ Owner Phone Number <br /> Owner's Address 6 00 64.35 t4Jr -o ` i r Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address Q �- <br /> JOB ADDRESS -1 43(7 645 s i...)004 c (V Z C p4t i yin t I l ` <br /> I S f LOT # <br /> SUBDIVISION DIrkaJDOCI PARCEL ID# 0 -2-6 `Z- 1 - 0 2 1 0 - co G v 0 / 1 O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT 1 SIGN 1 1 MOVE 1 1 DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I SFR I COMM I OTHER I <br /> TYPE OF CONSTRUCTION I / � 1 BLOCK I FRAME 1 1 STEEL 1 1 OTHER <br /> DESCRIPTION OF WORK 6 Q.. 1roc,- j „J ( At 3 () yf a v /19A /? J 4 ' // 5 Q <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> VA BUILDING $ 36 2- 3 , 3 VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ AMP SERVICE 1 1 PROGRESS ENERG - - -rTL W.R.E.C. <br /> c..._.______ ....) <br /> 1 I PLUMBING $ <br /> 1 ( MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION - <br /> 1 1 GAS ROOFING I 1 SPECIALTY 1 I OTHER 61 V1 / <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA 1 (YES 1 1NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address I License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY 1 <br /> SIGNATURE REGISTERED I Y/ N 1 FEE CURRENT I Y/ N I <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address y� / License # <br /> 1/ ei) <br /> OTHER COMPANY 1. N-1iPH <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I <br /> Address p e 0 X !! JJt J 77 J4 k "H PP Fr 3 v7 l° License # ( ( C 4)5 7 5 7 <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 (3) 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. (A/C upgrades over $5000) <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 (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (Plot/Survey /Footage) <br /> Driveways - Not over Counter if on public roadways..needs ROW <br /> i <br />