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sis-�ao-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> - Building Department <br /> Date Received �-�,3 ��� Phone Contact for Permittln � - � <br /> Owner's Name Owner Phone Number � <br /> O I E' o w�� ll���t �l Q � <br /> Ow�er's Address . L `' Owner Phone Number <br /> Fee 5imple Titleholder Name Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> 1 ��, � ,�. - ►=� 3��� a. l � � �oT # �� <br /> JOB ADDRESS <br /> SUBDIVISION �1 1 � �1 �-`� � PARCEL (D# O • c�- • � ° ' � �� G <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CoNSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> e INSTALL 8 REPAIR �p ���� <br /> PROPOSED USE Q SFR Q COMM � OTHER 1� <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK � C�C! +r � � O �-j�1 1`t <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ ���� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� <br /> OGAS � ROOFING Q SPECIALTY Q OTHER <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 /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Address License # <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/ N <br /> Add�ess License # � <br /> OTHER � COMPANY ��Y�'/ �l(� �� <br /> SIGNATURE � REGISTERED Y/ N FEE C RE� Y/ N <br /> Address S 1'L, ;>-��� I Ucense # o � � <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, ConsVuction Plans, Stormwater Plans wf Silt Fence installed, <br /> 5anitary Facilities 8 1 dumpster; Site Work Pennit 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 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. <br /> ""*PROPERTY SURVEY required for all NEW constructlon. <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 Faqulred (A/C upgrades over 57500) <br /> "` Agent (for the contractor) or Power of Attomey (for the owner) would be someone wlth notarized letter from owner authorizing same . <br /> OVER THE COUNTER PERMITTING (Front of Applicadon Only) <br /> Reroofs if shingles Sewers Serolce Upgrades A/C Fences (PIoUSurvey/Footage) <br /> ! <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />