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813-780-0020 City of Zephyrhills Permit Application G�( Fax-813-780-Oi 21 <br /> Building Departmen� <br /> � (�- � QQ 3�f� � <br /> Date Received / � � � �/ � � i <br /> Phone Contact for Permitting � (j __ '� � 7 <br /> Owner's Name �.J �� �-� Ui�} C L�. �(/'� (_ �l 3� Z� , <br /> Owner Phone Number � 7 � <br /> Owner's Address 92�p �� }L. ���S �" �� Owner Phone Number g� 3�( ?/y �� 1 <br /> Fee Sirriple Titleholder Name Owner Phone Number �� +o ��v S <br /> (c 2 3 - <br /> Fee Simpie Titleholder Address � <br /> JOB ADDRESS � y�(,� (?�- � S� f v <br /> LOT # ; <br /> SUBDIVISION (�� i-" Cl�� ��S� , pqRCEL ID# � � �(O Z � (.� Z?j,, (Jp u p(`j Z!� v � <br /> (OBTAtNED FROM PROPERTY TAX NOTICE) I <br /> WORK PROPOSED e NEW CONSTR B ADD/ALT SIGN <br /> INSTALL REPAIR �� � 0 DEMOLISH <br /> PROPOSED USE � SFR Q COMM C� OTHER <br /> TYPE OF CONSTRUCTION � BLOCK FRAME � <br /> CI [ � STEEL Q <br /> DESCRIPTION OF WORK I�'�?� L�. L� �J (�Q ��� L C>�Lf/�1��-r[.l s�'T S�� <br /> BUILDING S12E SQ FOOTAGE �� <br /> HEIGHT <br /> �BUILDING $ �z7 <br /> � D�� Q� VALUATION OF TOTAL CONSTRUCTION � <br /> �ELECTRICAL $ AMP SERVICE I <br /> 0 PROGRESS ENERGY [� W,R.�.C. <br /> OPLUMBING $ <br /> � I <br /> [�MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� �-" � I <br /> �' � <br /> QGAS Q ROOFING Q SPECIALTY C� OTHER I <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA DYES NO <br /> BUILDER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address ' License # �_ � <br /> ELECTRICIAN ��� /��/' � COMPANY D T S� �- � 1 ! � <br /> SIGNATURE v�� REC�ISTERED I <br /> Y/ N FEE CURRE� Y/ N I <br /> Address �.- <br /> L(cense # �� �� �� S 1 Z, �j <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License � i <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N I <br /> Address <br /> License # <br /> OTHER COMPANY • <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # �- <br /> i <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 subdivisions/targe 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 constructionl <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence insta`led, <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. I <br /> ""*'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized I <br /> If over $2500, a Notice of Commencement is requlred. (A/C upgrades over;7500) <br /> "* Agent (for the contractor) or Power of Altomey (for the owner) would 6e someone with notarized letter from owner authorizing same I <br /> �VER THE COUNTER PERMITTING (Front of Application Only) <br /> 4eroofs if shingles Sewers Senrice Upgrades A/C Fences (Plot/Survey/Footage) i <br /> Driveways-Not over Counter if on public roadways..needs ROW <br /> I <br />