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s�saso-oo2o City of Zephyrhills Nermit Application Fax-lfl3-lSU-OU11 <br /> Building Departmen[ <br /> Date Received Phone Contact for Permittln — <br /> Owners Name �'"�- V•.J - � SS� Owner Phone Number �( � � � ?l � �� �� <br /> Owner's Address ��o I vV"� �J`� !E-> r Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS L � 0�� O� �' (` Y� � � t 33s y a LOT # � <br /> SUBDIVISION , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e N TALLSTR �] REPA R T 0 SIGN Q Q DEMOLISH <br /> u <br /> PROPOSED USE SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK �.,`K(9V� Q� � � <br /> BUILDING SIZE � 3Q FOOTAGE HEIGHT <br /> QBUILDING $,� ) �� VALUATION OF TOTAL CONSTRUCTION <br /> C <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING � . ��` _. <br /> JI Y <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALN Q OTHER <br /> ���� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER y , n � � COMPANY �� � � � � <br /> SIGNATURE /' ��W`-�/ REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address 7l� ��-� �' e� License # l� d��d � � <br /> ELECTRICIAN � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # � <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N � <br /> Address License # � <br /> MECHANICAL �— COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Ucense # � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> RESIDENTIAL Attach {2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-0-W Permit for new wnstruction,. <br /> Minimum ten (10) working days after submittal date. Required onsite, ConstrucUon Plans, Stormwater Pians w/ Silt Fence installed, <br /> Sanitary Facillties & 1 dumpster; Site Worlc Permit for subdlvisions/large arojects <br /> COMMERCIAL Attach {3) complete sets of Bullding Plans plus a Life Safety Page; (1) set of Energy Forms. R-O-W Permit for new construction. <br /> Minimum ten (10) wo►king days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facllities 8 1 dumpster. Site Work Permit for all new projects. Atl commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Plans. <br /> ""'PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Confractor sign back of application, nota�lzed <br /> If over s2500, a Notice of Commencement is required. (AIC upgrades over;7500) <br /> *" Agent (for the contractor) or Power of Attomay (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (�ront of AppUcatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />