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3�s-7so-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received {/ <br /> � �� / Phone Contact for Permitting p�3 �,�- ' --��(�� - <br /> �`r" ��' <br /> Owner's Name e. Owner Phone Number <br /> Owners Address �� � � /v!� L�,k, J,/ �,i� � Owner Phone Number C <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simple Titleholder e ,� :� <br /> JOB ADDRESS � CLt�A IO�• � � ��.3 LOT# � <br /> SUBDIVISION PARCEL ID# �- a�S ' �/ -6�dU �d 3GY} -1X� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK a FRAME � STEEL � C <br /> DESCRIPTION OF WORK �iU�YiI�I U Y /��/rj')U Q�� <br /> BUILDING SIZE SQ FOOTAGE ` % HEIGHT <br /> �-rr�-rr■rr�*�� ���r-r-�r�r�r-r-r-� ��r-rr-�r�r+r�-r+rr*r <br /> �BUILDING �/� ���� VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> OPLUMBING $ �''I ���� ^'����S�y' , <br /> � ���"'�p���°"�-- <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �B`' �.� '��1y�5��� <br /> � � <br /> �GAS � ROOFING � SPECIALTY � OTHER ��� � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO �� <br /> BUILDER• ----__ / _-- _— p�•COMPANY^—U�_ • • —___`(� •�� O ��� <br /> SIGNATURE .G REGISTERED / N FEE CU�� � <br /> Address �/U� W • �/ e C�L/ � �Ul1 �/�, ��.- ,��,�'�'!� License# � • <br /> ELECTRICIAN '�— � COMPANY �r�i G/��7 �G ��� <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address � /� / r/C��/ �� � 33�O�S'�License# C <br /> T� <br /> PLUMBER � " " j ���// �� COMPANY ������1 <br /> SIGNATURE �X/ <1i�AG��/v- REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �J '�t� S / U�y �� c��j/ License# C <br /> . �J_ G(5T, <br /> MECHANICAL ., COMPANY C� �"�'T �C �- !�-E�Q.�.jll <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address b O �n I' � �3�.�'�� License# �� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# � <br /> � � � � � � � � � � � r � EE ' e � � � � � � � � � � � rr ` e � � � � � iii � � � irr � � � � i � � � � � irr � � s , i � � i <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new constructian, <br /> Minimum ten(10)workirg days after submittai tla[e. kequired onsiie,Corisiruciiu��ria���,Siur��.rat�� Flar,s�.,'��„, ..,,,,�„�,,,�.;�d, <br /> Sanitary Fac:lities&? dumpster;Site N!ork Permit for subdivisicns;;arr�e projects <br /> COMMERCIAL AttacFi(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 construction. <br /> ��������� • • ■ ������� !� M ■ ������� S t • �� • t p i • ■ <br /> Directions:• '--- <br /> Fill out application completely <br /> Owner 8�Contractor sign back of applicatior�,notarized <br /> If over a2500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> *' Agent(for the contractor)or Power of Attorney(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(PIot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />