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s�saso-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date-'eteceived Phone Contact for Permittin — <br /> Owner's Name (" � � C'r Owner Phone Number � 3 ' y 1 7 - 3`��� <br /> Owner's Address �� �� �� �� � / - Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS a "` � r LOT # � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX N077CE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM 0 OTHER <br /> TYPE OF CON3TRUCTION BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK Il od F E' Il� s�l /� (r- <br /> BUILDING SIZE SQ FOOTAGE l DUU HEIGHT <br /> QBUILDING $� �� r�� VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> 11 � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUI�DER , ]� / � - COMPANY O Lv7'l 8Y� <br /> SIGNATURE ✓ � G(//� NG. REGISTERED Y/ N FEE CURRE� Y/ N <br /> Add�ess ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y! N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <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-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 Faeilities 8 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 /> Owne� 8 Contractor�sign back,of application, notarized <br /> If over $2500, a Notice of Commancement is required. (AIC upgrades over 57500) ' ' <br /> ** Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized �etter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A!C Fences (PlodSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />