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� 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � �� <"` <br /> Phone Contact for Permittlng jj� �� _��/ <br /> � � � � t � � I � � � i 1 <br /> Owner's Name Owner Phone Number <br /> Owner's Address �S �d Owner Phone Number �� <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fce Simple Tkleholder Address —� <br /> JOB ADDRESS �E�3 �Acas� .� • LOT N N..� S <br /> SUBDIVISION �/A PARCEL IDN �T e�L/ � �I �Oa.� O "�DOO — /, � O <br /> (08TAMIED FROM PROPER7V TA)( NOTICE) <br /> WORK PROPOSED e NEW CoNSTR e ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TVPE OF CONSTRUCTION Q BIOCK Q FRAME � STEEL Q <br /> w M�s /ro - A ei-I �F + t> o,v D r <br /> DESCRiPTION OF WORK /'�p � � <br /> BUILDING SIZE SQ FOOTAGE `�' / HEIGHT <br /> QBUILDING $�? ,SOO' VALUATION OF TOTAL CONSTRUCTION <br /> LECTRICAL $, . AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> o•� <br /> �PLUMBING $ � ` � / � ` C ^ <br /> � 7 '� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS �� FLOOD ZONE AREA QYES NO <br /> BUILDER i� J �� I 1� COMPANY �N �NSTj24lL� TjDf� � <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address 7(.6IS�/D/7'/S � � License # S� � <br /> ELECTRICIAN ��COMPANY � ,�TQ <br /> SIGNATURE REGISTERED Y/ N F� curtaen Y/ N <br /> Address � /� � Z' License # �0�075 �� <br /> PLUMBER / /� COMPANY � fL u � <br /> S��TV� L' �� ` REOISTFRED Y/ N FEE CURREA Y/ N <br /> Address C C l LV l/ � Il License # � � <br /> MECHANICAL � COMPANY —� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Addresa License # <br /> OTHER COMPANY <br /> SIGNATURE REC,ISTFRED Y/ N FEE CURREh Y/ N <br /> �d�� License # � <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIt11111111111111111111111 <br /> RESIDENTIAL Atfach (2) Plot Plans; (2) sets of Building Plans; (t ) set of Energy Fortns; R-O-W Pertnit for new construclion, <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary FadliGes & 1 dumpster; Site Work Pertnit for subdivisionsAarge projects <br /> COMMERCIAL Attach (3) complete sels of Building Plans plus a Life Safety Page; (1) set of Energy Fortns. R-O-W Pertnit for new constniction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Consiruction Plans, Stortnwater Plans w/ Silt Fence insfalled, <br /> Sanitary Facilities 8 1 dumpster Site Work Pertnit for all new projecLS. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engi�eered Plans. <br /> "'•PROPERTY SURVEY required for all NEW construction. <br /> D�reet�ons: • <br /> Fiil out application completely <br /> Owner & Contractor sign back of appliption, notarized <br /> If over 52500, a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent (for the contrector) or Power of AKomey (for the owner) would be someo�e with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIITING (Fmnt W ApplicaGOn Only) <br /> Reroofs H shingles Sewers Service Upgrades A/C Fences (PIoUSurveylFootage) <br /> Driveways-Not over Counter if on public roadways .needs ROW <br />