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a�-�so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Departmen� <br /> Date Received '� <br /> Phone Contact for Permittin _ <br /> Owner's Name b�l � � — (/�G/Qs�f7 <br /> Owner Phone Number <br /> Owner's Address � C I f� � /g`� - Owner Phone Number � —� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3 �! / Z � �L`� LOT # �� <br /> SUBDIVISION , PARCEL ID# �! ` 2 a'' ��'" OO/O—�D �0�' - Ql�l� <br /> �OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT �] SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION [� BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK '" � '' �. <br /> BUILDING SIZE SQ FO A� <br /> HEIGHT <br /> OBUILDING $ +.- <br /> �`�S� VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY �, W,�.�.C, <br /> / , <br /> QPLUMBING $ � <br /> � �� ! <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �-� / <br /> � <br /> OGAS [� ROOFING Q SPECIALTY � OTHER --�"� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES 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 /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address Lfcense # � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address <br /> License # <br /> OTHER ' ��^ COMPANY �/'Ql�j'w� ���%�✓�' <br /> SIGNATURE — REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address b� K ) (_ ��� �; L� License # /�' C DOG 6Z � <br /> RESIDENTIAL Attach (2) Plot Plans; (2) sets of Buliding Plans; (1) set of Energy Fonns; R-O-W Permit for new construction, <br /> Minimum ten (10) wortcing 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/ Silt Fence installed, <br /> Sanitary FaciliGes & 1 dumpster. Site Work Permit for all new projects. All commerciai requirements must meet compliance <br /> 51GN PERMIT Attach (2) sets of Engineered Plans. <br /> '"�"PROPERTY SURVEY required for all NEW constructlon. <br /> �irections: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application, notarized <br /> If over;2500, a Notice of Commencement (s required. (A/C upgrades over 57500) <br /> " Agent (for the contractor) or Power of Attomey (for the owner) would be someone with notarized letter from ovmer authorizing same <br /> )VER THE COUNTER PERMITTING (Front of Application Only) <br /> teroofs if shingles Sewers Senrice Upgrades A/C Fences (Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />