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s�saeo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received /l 02 3 Phone Contact for Permitti� — <br /> Owner's Name h�/If ��� �L-� Owner Phone Number �J� � �O� " �` � <br /> Owner's Address o�� � � �! ' Owner Phone Number <br /> Fee Simpie Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � / � �� LOT # � <br /> SUBDIVISION , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK DD� h��o ��}� � � � D �' / �L� ���VS (: Di2fP1�� � � <br /> BUILDING SIZE � SD FOOTAGE �� HEIGHT �� <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION ��` ���• � <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> � �V <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ��/ <br /> G' <br /> �GAS .� ROOFING Q SPECIALTY 0 OTHER ,�� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � <br /> BUILDER s COMPANY �`��� �LAID UtI �� N�* <br /> SIGNATURE REGISTERED Y/ N FEE CU E� Y/ N <br /> Address 7 [ � � � �'C���"� (� J�Q�II�y ���` � License # C�C D�3 � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # —� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREF 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 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 8 1 dumpster; Site Work Permit for 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 construction. <br /> Minimum ten (10) working days after submittal date. Required onsite, Construction Plans, Stormwater Plans w/ Sitt Fence installed, <br /> Sanitary Facilities & 1 dumpster. Site Work Permit for all new p�ojects. All commercial requirements must meet compliance <br /> SIGN PERMIT Attach (2) sets of Engineered Pians. <br /> *"'"PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized <br /> If over 52500, a Notice of Commencement is required. (AlC 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 PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />