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813- 780 -0020 City of Zephyrhills Permit Application Fax -813- 780 -0021 <br /> Building Department 21 <br /> Date Received I Phone Contact for Permitting 7- 3 t0 t� / __ Lig e J <br /> • <br /> Owner's Name LY - r+ 5 P' i r l /� -O C Owner Phone Number <br /> Owner's Address 3 b 4 4 L I 9 A VP Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address f ,y 1 <br /> JOB ADDRESS b S D 1A - 1 , Y e. 2e_p y �„ ) \s j /"L 33 s1 a- LOT# <br /> SUBDIVISION Acare..s PARCELID# 3 -a&' a ) -b ) b) - OP 006 - OOLZ <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE n SFR n COMM n OTHER <br /> TYPE OF CONSTRUCTION Ti BLOCK � n FRAME In STEEL n OTHER I R„�� ' <br /> DESCRIPTION OF WORK 5t ( ) ITS p b b-Vo v P,b' - t - (1 a Pi-1-th - FLSY Yzi <br /> BUILDING SIZE SQ FOOTAGE /5".' HEIGHT <br /> WI BUILDING $ ;3)4/ o0 <br /> VALUATION OF TOTAL CONSTRUCTION <br /> / as, <br /> n ELECTRICAL I $ AMP SERVICE n'] PROGRESS ENERGY n W.R.E.C. <br /> n PLUMBING $ <br /> I MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> n GAS ROOFING n SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA nYES nNO <br /> Ro elr A me r)Ca r)P - D 5Sil�rXp9 Rev; <br /> SIGNATURE 7 c ( <br /> COMPANY <br /> I Y/ N I FEE CURRENT 1 Y/ N <br /> Address f 1O) C)✓)? a )-,X L- 31: �l License# �C i� n- 73 <br /> ELECTRICIAN D COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address License # I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED 1 Y/ N I FEE CURRENT I Y/ N I <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT 1 Y/ N I <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 (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 />