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e�s-�ao-oo2o City of Zephyrhills Permit Application Fax-�813-780-0021 <br /> � Budding Department <br /> Date Received �° �,/� /3 �p� -•/�� <br /> � � � �.c � � � Phone ConWct for Pertnitting 0 <br /> 1 1 1 i 1 <br /> Owner's Name � � Owner PAone Number �� '�p'- //S p <br /> Owners Address �7 y l �° � Owner Phone Number � <br /> Fee Simple Titleholder Name �- � Owner Phona Number � <br /> Fee Simple Tkleholder Address � <br /> JOB ADDRESS 3���� /`���HL /7 LOT it �� 3I <br /> SUBDIVISION � � lS/ PARCEL IDN ll3 alo�3/,fJl3D -/7f1/DD-Od'-!U <br /> (OBTAINED FROM PROVERTV TAl(NOTICE) <br /> WORK PROPOSED B NEW[oNSTR B ADD/AlT Q SIGN Q � DEMOI.ISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM O OTHER � <br /> TYPE OF CONSTRUCTION � BLOCK O FRAME Q STEEL Q �-� <br /> DESCRIPTION OF WORK 1�/Zr�`�'� fi X�FM.S�O� � <br /> BUILDING SIZE !T/��Q SQ FOOTAGE °�OO HEIGHT � <br /> BUILDING $ I<}`� ,�S' VALUATION OF TOTAL CONSTRUCTION <br /> � C�� <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R E.C. <br /> QPLUMBING $ ^�`/`�(,J <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION �� `J <br /> � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER .i COMPANY �I/ ��� � �T7�� � <br /> SIGNATURE � /�� �� REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrass (l - � C " � / ' License# C.'P�S7�0�� <br /> ELECTRICIAN Cpry�pqNy � <br /> SIGNATURE REGIS7ERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address � <br /> License# <br /> MECHANICAL COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address _� <br /> License# <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addrass � <br /> License# <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIN1111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)seTS of Building Plans;(1)set oT Energy Fortns;R-0.W Pertnit tor new constniction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Constniclion Plans,Stormwater Plans w/Silt Fena:installed, <br /> Sanitary Faalities&1 dumpster;SHe Work Permit for subdivisians/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(t)set of Energy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)working days aNer submittal date. Required onsite,Construction Plans,Slortnwater Plans w/Silt Fence instailed, <br /> Sanitary Fadlities&1 dumpster Site WorVc PermN for all new projects.All commercial requirements must meet complianc:e <br /> SIGN PERMIT Attach(2)sels of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construdion. <br /> Dvecbons.• <br /> Fill out application completely <br /> Owner&Contraclor sign back of application,notarized <br /> If over 52500,a Notice of Commencemen!is required. (A!C upgrades over i7500) <br /> '" Agent(for the contrector)or Power of Attomey(for lhe owner)would De someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgredes A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways needs ROW <br />