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813 -780 -0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> 0 e'' 2) <br /> Date Received Phone Contact for Permitting Fit C – ORM <br /> -- -- - - - - -- <br /> iIIIIIIIIIIIIItW_I9_ <br /> Owner's Name <br /> ` T1 t' A?A1SeA\ Owner Phone Number 813 - -Y3 `J %�,.) <br /> Owner's Address I t S 0 3 r), V ' Si Owner Phone Number <br /> Fee Simple Titleholder Name psi 1/1 Owner Phone Number <br /> Fee Simple Titleholder Address j / <br /> JOB ADDRESS 'Igo L.+ � 3 c L (& .S �th € r �1 LOT # <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED I I NEW CONSTR ADD /ALT n SIGN n MOVE n DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE I I SFR I I COMM n OTHER I <br /> TYPE OF CONSTRUCTION n BLOCK I I FRAME I I STEEL I I OTHER I <br /> DESCRIPTION OF WORK 3q a kli'4( V 'n Q - &o f) <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> BUILDING $ ;6 ' ' 1 . 7-.? / /D o a VALUATION OF TOTAL CONSTRUCTION <br /> • <br /> I I ELECTRICAL $ AMP SERVICE 1 I PROGRESS ENERGY I W.R.E.C <br /> I I PLUMBING $ <br /> I 1 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> n GAS n ROOFING 1 1 SPECIALTY n OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA I IYES =NO <br /> BUILDER <br /> �, ,� - " "°._._ . COMPANY 5, UR c!(.. • <br /> SIGNATURE 1 ,t REGISTERED Y/ N I FEE RENT Y/ N 1 <br /> Address 1 •‘ti Z <br /> - µ 335 License # leccosei a <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 <br /> Address 1 License # I I <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N 1 <br /> Address License # <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED I Y / N 1 FEE CURRENT 1 Y/ N I <br /> Address License # I I <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 />