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s�s-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> ' 79l� <br /> Date Received � l� � phone Contact for Permitting 0[ 3 /' � <br /> 1 1 1 1 1 1 1 1 1 1 1 i 1 <br /> Owner's Name �-+ m� x� Owner Phone Number Q' p��' ��O � �� / <br /> Owner's Address 7��� A � LvD Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � LL, LV LOT # � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEw CON57R B ADDlALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER OYV !� ys <br /> TYPE OFCONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � C-�� � S< S �J�ISTr} �'rJ� <br /> BUILDING SIZE SQ FOOTAGE � HEIGHT � <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $� ' J AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> ,�, vo�ra yc,� <br /> �PLUMBING $ � <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �' �� <br /> � <br /> �GAS Q ROOFING Q SPECIALTY O OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � License # <br /> ELECTRICIAN COMPANY cl r f7✓VJ-Z' TItL ,� /��I�J <br /> SIGNATURE REGISTERED N FEE CURRE� Y/ N <br /> Address License # �6 <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> luldress License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address License �k <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/ N <br /> Address �Z�� D3�n5 #'� 'j1�YY►PH� L33G3y License# LF` <br /> �i�������������������i�����ii����������ii�����ii�����i���i��i��i��� <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Building Plans; (1) set of Energy Forms; R-O-W Pertnit for new construction, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stortnwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities & 1 dumpster, Site Work Pertnit for subdivisions/large projects <br /> COMMERCIAL Attach (3) complete sets oi Building Plans plus a Life Safety Page; (1) set of Energy Fortns. R-O-W Pertnit for new conslruction. <br /> Minimum ten (10) working days afler submittal date. Required onsite, Conslruction Plans, Stortnwater 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 construdion. <br /> Directions: • <br /> Fill oul application completely <br /> Owner 8 ConVactor sign back of applicatlon, notarized <br /> If over E2500, a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (PIoUSurvey/Footage) <br /> Driveways-Not over Coun[er'rf on public roadways..needs ROW <br />