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qtqC1 <br /> 813-780 -0020 City of Zephyrhills Permit Application Fax -813 -780 -0021 <br /> Building Department t AA A) ' ll <br /> '" ` �O G L a � c� ! ► /tom <br /> Date Received , <br /> S-'(© .- , 1 Phone Contact for Permitting I r ffia - 4 <br /> Owner's Name 4 # 7 " „1 I`-L Owner Phone Number <br /> Owner's Address Owner Phone Number 1 <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address [ <br /> JOB ADDRESS - 7 6 7 4 1 - 0 int- gLVL . r 1 rety oV c y l5�" LOT # <br /> SUBDIVISION PARCEL ID# <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 rac COMM Q OTHER <br /> TYPE OF CONSTRUCTION n BLOCK p n FRAME <br /> � //' / , = STEEL n OTHER I <br /> DESCRIPTION OF WORK [ oFt- cor Vi Cs-r � pm 4kL is 7 <br /> BUILDING SIZE I X 1 .g SQ FOOTAGE / 11 HEIGHT (0 <br /> fttommttotattittEttfttmatitottlitm <br /> n BUILDING ( Zi t S ` 00 VALUATION OF TOTAL CONSTRUCTION <br /> n ELECTRICAL AMP SERVICE n PROGRESS ENERGY n W.R.E.C. <br /> n PLUMBING <br /> n MECHANICAL VALUATION OF MECHANICAL INSTALLATION <br /> I GAS n ROOFING I 1 SPECIALTY OTHER <br /> FINISHED FLOOR ELEVATIONS [ FLOOD ZONE AREA nYES El NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address ( License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address I License # I <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address I License # 1 <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/ N I <br /> Address ( License # I i l <br /> OTHER 7 /44 ` COMPANY l sC /✓" <br /> SIGNATURE 2 ,, �7 REGISTERED I Y/ N I FEE CURRENT' I Y/ N I <br /> F#4)( Address Q #4)S /`L I�.cvtw Da -. , 'PA ( 3 .7 619 License 1+ <br /> IffilMIONSMINIZSMINVIERIMIORM <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R -O -W Permit for new nstruction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Storm ter 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 NC Fences (Plot/Survey /Footage) <br /> Driveways -Not over Counter if on public roadways..needs ROW <br />