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� <br /> 813-780-0020 City of Zephyrhills Permit Application �1�Z � Fax-813-780-0021 <br /> Building Department ��i, <br /> i���� <br /> Date Received ��3' �� � _ C�� <br /> Phone Contact for Permittin <br /> Owner's Name r l � '� ��� r0 2�'T� �5 �� � Owner Phone Number t%�2 /�p �1 U 7� <br /> Owner's Address l t 1 � �C Mi 11f�) � (tt M� . � �'"� �Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> J08 ADDRESS �O 1 O`f ` �---N LOT# � <br /> SUBDIVISION , PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B New CoNSTR� 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 , L U C "c�� v �v.% . (� <br /> BUILDING SIZE SQ FOOTAGE ���� HEIGHT <br /> OB ILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ ��,> bC6 AMP SERVICE �Q PROGRESS ENERGY Q W.R.E.C. <br /> �PIUMBING $ <br /> � ' �� I� J �( <br /> MECHAN�CAL $ VALUATION OF MECHANICAL INSTALLAT�ON ✓ <br /> \ �--------._ <br /> �GAS Q ROOFING Q SPECIALTY [� OTHER � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO �� <br /> � <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address ' License# � <br /> ELECTRICIAN f�� �"""��' � """``""-...,� COMPANY 1�(� � '�, L <br /> �^� -- `>_>,�...-",. <br /> SIGNATURE �.ii'� `—=`~':�--' =�.- __. �_ _..__,__„_ _ � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �iy��1 � kS u I�P��� License# �� ��6 ( �y � <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 Llcense# <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 /> Minimum ten(10)worVcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safery 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 Ptans. <br /> "'"*PROPERTY SURVEY required for all NEW construcdon. <br /> �„��„���,����.�� <br /> � <<�.a.a i at�.�i��u �r <br /> Directions. <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,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 Sewe�s Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />