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a�a-�au-uu�u City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recelved /� � <br /> J /`�' hone Contact for Permit ' �� 3 Cf ' _ Q$ � 5 <br /> Owner's Name `- �'1 u2<= }'� a F ��'1 R��� Owner Phone Number <br /> Owner's Address 5 4 4 y �t brt . `- N i I) S '�.5 `� �- pWner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Numbe� <br /> Fee Simple Titieholder Address <br /> JOB ADDRESS S 4 � �{ ��+ �f', � _ y ; � �s � � � y � <br /> LOT # � � - � c� <br /> SUBDIVISION , PARCEL ID# ��- r� �" oZ �- O o\ p c) roj c�- n,� p <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR � ADD/ALT [—� SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM �� OTHER <br /> TYPE OF CONSTRUCTION �� BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK <nC'J (� C'..n,uC Rx � �C. IQrI(� i�'i r N �N F y( ��' � r� �� �� <br /> � <br /> BUILDING SIZE �� � X�q � d f SQ FOOTAGE v� HEIGHT ��� <br /> OBUILDING $ � I a � � `"� <br /> r��j VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ � �, �' AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> Q .? p , <br /> QPLUMBING $ �, _ � �\'�� <br /> / �_ <br /> �MECHANICAL $�� a VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES NO <br /> BUILDER COMPANY �6� H���Qu Cc�t�_ '�.NC - <br /> SIGNATURE ��� � <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> 14f�f�f85S ���-'! yr� CJ�' ! 5 p (,r�.' R.f� ' z- (-{i (�< ��4 <br /> License #�= Q �° y% J o� � <br /> ELECTRICIAN COMPANY �� Cl4x �lr� � <br /> SIGNATURE �'t REGISTERED Y/ N FEE CURRE� Y/ N <br /> i <br /> Address � S ��+.� � <br /> License # - ��'�' d -z �O <br /> PLUMBER x /� COMPANY Oy'� <br /> SIGNATURE � Y REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL � COMPANY ��Q fL ;1 /� t� a � N� � .q,S � ff/ � <br /> SIGNATURE REGISTERED Y/ N FE CURRE� Y/ N <br /> Address �� f�✓ �'�� f <br /> License # Y� �y8 <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA 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 Facilities & 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 /> M�nimum 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 construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If aver $2500, a Notice of Commencement is required. (A/C upgrades over;7500) <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 Counter if on public roadways..needs ROW <br />