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u,�-�uu-uuzu City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department , <br /> iv,N GLEu <br /> Date Receiv�d <br /> "� � Phone Contact for Permitting �' �� 3� _ �,�, a <br /> Owner's Name r E Pj �C `^ � 1'}�} 7 r S T � L'/� Owner Phone Number � � 3 7 0/-��f� F' <br /> Owner's Address �l � 3 S �t-�} �j,� � � q�� .- �L -N ��,. 5 3 3S`/ Owner Phone Number � j 3- a� �� - y� 5� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �j 7 35 �' }1� N� �, 7 Q, �� � Z� r � � y F • 3 3 S y� LOT # �� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT [� SIGN � --7 DEMOLISH <br /> INSTALL 8 REPAIR �� - - " -- �"' — ' 1 — •, <br /> � _ _ , <br /> PROPOSED USE Q SFR Q COMM � OTH ,� U 17 tiDhlS oN1 <br /> TYPE OF CONSTRUCTION O BLOCK Q FRAME � STEEL <br /> DESCRIPTIONOFWORK �i.+5��tit,»� „ b 7�ti 5 o�s �, 7�y�_ Pp�t�►8�� {�vitn�vC S <br /> BUILDING SIZE ��� n �'I � ��= � 3Q FOOTAGE L 5� � HEIGHT ��T • <br /> QBUILDING $ ,_, <br /> ! v, c� v c VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBWG $ � � � h � � <br /> r� L/ <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> l <br /> BUILDER ✓ ���•�' �l COMPANY ,vaN S'fiN� ��,vSTlzdC7�cr✓ <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address � / �t 5" S 7 � <br /> License # C�L' 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 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. Requfred onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster; Site Work Permit for subdivisionsAarge 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 8 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 constructlon. <br /> Dtrections: <br /> Fill out application completely. <br /> Owner 8� Contractor sign back of application, notarized <br /> If over $2500, 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 PERMITi't1�M - (Front of Appiication 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 />