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813-780-0020 City of Zephyrhills Permit Application Fax-813-780- 1 � � <br /> Building Department � <br /> Date Received � �'�� - j�_' <br /> i Phone Contact for Permitting _ <br /> Owner's Name ( J �{ `� /�I� r Owner Phone Number l�� ' Q ���� <br /> �33S ` C <br /> Owner's Address S f Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS L -� S�o( /0/1 � y� 3/Y S I� �u� q c•G� ��(/L� <br /> LOT# C� <br /> SUBDIVISION PARCEL ID# <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 Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q � <br /> DESCRIPTION OF WORK v �/C �C/�CC <br /> � � , ( � <br /> BUILDING SIZE .�q FOOTAGE ���`' HEIGHT <br /> QBUILDING <br /> 1 7�y VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> OPLUMBING $ , <br /> ,� n���� <br /> MECHANICAL � / <br /> � $ VALUATION OF MECHANICAL INSTALLATION � <br /> �GAS [� ROOFING Q SPECIALTY [� OTHER � ��� "� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �� <br /> BUILDER COMPANY ,�I � L-/S (.5� �(/Y%� li� l=� <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address S/SC G S �ac� �-�i License# 3� G�� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address License# C <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/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permwt 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 aii NEW construction. <br /> Directions: <br /> Fiil out application completely <br /> Owner 8 Contractor sign back of application,notarized <br /> If ove�$2500,a Notice of Commencement is required. (A/C upgrades over 57500) <br />" Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized fetter 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 />