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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date FYeceived Z_2 : , �_ <br /> Phone Contact for Permitting _ <br /> Owner's Name �O l� �, � � q vi Owner Phone Number 0��J -99 - 7���- <br /> Owner's Address �g�o �j �,Qn ���� �/ Owner Phone Number � <br /> Fee Simple Titlehoider Name Owner Phone Number <br /> Fee Simple Tifleholder Address <br /> JOB ADDRESS ��G 5 � �.Clsv S i`i, �y'� LOT# ��J <br /> SUBDIVISION - PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEw CoNSTR ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR a COMM � THE Q Q c.� <br /> TYPE OF CONSTRUCTION �] BLOCK Q FRAME �� STEEL Q <br /> DESCRIPTION OF WORK . G �x C i n �(p�✓S' � <br /> BUILDING SIZE � 3Q FOOTAGE�� HEIGHT <br /> �BUILDING $ � <br /> �C VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> l.�' '�./� <br /> �ivFEeNFCIQfCAL $ f U U ALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER ?/�J r U <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �� <br /> DYES NO <br /> UILDER �`� <br /> (� COMPANY ���- ��/I �.� <br /> - `fi1GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# � <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 /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� 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 /> Minirrium 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/Silt Fence installed, <br /> Sanitary Facilities 8 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 construc6on. <br /> Dlrections: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over a7500) <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_ S � ; <br /> CJ� �'L/iQ./� / ��r� f,GL �P��� ' � C� w <br />