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e�a-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> • Building Department I � _ I / / � � <br /> =, ! r` <br /> Date Received <br /> Phone Contact /or Permittin <br /> Owner's Name j ��� Owner Phone Number ��� - .3�`G� � <br /> Owner's Address s� J�' � T J/_ � Owner Phone Number <br /> Fee Simple Titleholder Name �� Owner Phone Number <br /> Fee Simple Titleholder Address �/ <br /> JOB ADDRESS �� "� � � . � 7 �f � j S7Z LOT # (� � S'f <br /> SUBDIVISION -� pARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT Q SIGN Q MOVE Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME Q STEEL Q OTHER <br /> n � / <br /> DESCRIPTION OF WORK /�'� S. n - in � �ira �v ��/� _Si{, � �; �/,� � <br /> BUILDING SIZE SQ FOOTAGE H E I GHT <br /> Q BUILDING $� �- s� VALUATION OF TOTAL CONSTRUCTION <br /> Q ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R E C. <br /> Q PLUMBING �$ <br /> � <br /> Q MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> Q GAS Q ROOFING � SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS � � FLOOD ZONE AREA �YES �NO <br /> BUILDER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> ELECTRICIAN COMPANY -� <br /> SIGNATURE REGISTERE� Y J N FEE CURRENT Y/ N <br /> Address <br /> License # <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address � � <br /> License # <br /> MECHANICAL COMPANY -� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/ N <br /> Address License # <br /> OTHER COMPANY � � � (�' � <br /> SIGNATURE REGISTERED Y! N FEE CURRENT f Y/ N <br /> � y� ' / �, �.,. <br /> Address � � � , � License# �Crl. � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-W Pertnit 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 onsde, Construclion Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster Site Work Permit for all new pro�eds All commeraal raquirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans <br /> ""PROPERTY SURVEY reqwred for all NEW construction. <br /> Directions: <br /> Fill out application completely <br /> Owner 8 Contractor sign back of epplication, notarized <br /> If over E2500, a Notice of Commencement is required. (A!C upgredes over 55000) <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 PERMITfING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways. needs ROW <br />