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� a�s-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received phone Contact for Permittin � 4 �— � <br /> Owner's Name 1�f1 �� S 1'� Owner Phone Number �I •��� "�� <br /> Owner's Address <br /> � (�� �~ �� Owner Phone Number �— � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> `"' �r h� r 33SU LOT # �� <br /> JOB ADDRESS � • <br /> SUBDIVI310N . PARCEL ID# ��' - O�I •C� � O <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT SIGN Q Q DEMOLISH <br /> INSTALL REPAIR (Ze tZ.00F <br /> PROPOSED USE � SFR Q COMM OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �eC1f� O�r Q.(`C� L¢ ' � � ��j'� �( <br /> BUILDING 51ZE SQ FOOTAGE �� HEIGHT <br /> QBUILDING --- VALUATION OF TOTAL CONSTRUCTION <br /> , � �— <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS EA�ERGY W.R.E.C. <br /> OPLUMBING $ � <br /> � � �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � <br /> OGAS � ROOFING Q SPECIALTY � OTHER � C' / <br /> � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y! N <br /> Address ' License # <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address LiCense # �— <br /> PLUMBER COMPANY <br /> 31GNATURE REGISTERED Y! N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/ N <br /> Address License # <br /> OTHER COMPANY rYl�i(1 (�rl <br /> SIGNATURE REGISTERED Y/ N FEE C REA Y/ N <br /> Address � 5 � License #� � ��+QS <br /> RESIDENTIAL Attach (2) Piot 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/ Sflt Fence installed, <br /> Sanitary Faciflties & 1 dumpster; Site Woric Permit far 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 constructlon. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Silt Fence installed, <br /> Sanitary Facilitles 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 construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner & Contractor sign back of application, notarized <br /> If over 52500, a Notice of Commencement is required. (A/C upgrades over 57500) <br /> ** Agent (for the conUactor) or Power of Attomey (for the owner) would be someone with nofarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applicatian 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 />