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s�s-�ea-oazo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date,Received Phone Contact for Permitting _ <br /> Owner's Name �/r� f Owner Phone Number <br /> Owner's Address %'" rc „ , Owner Phone Number �a�- .z . -,3-3 <br /> Fee Simple Titleholder Name Owner Phone Number -� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 1'J �, `* � � 1� l 1 �S LOT# � <br /> SUBDIVISION , PARCEL ID# � - - ,`� _ - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B 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 � STEEL Q <br /> DESCRIPTION OF WORK � � <br /> / <br /> BUILDING SIZE SQ FOOTAGE � �� HEIGHT �� <br /> QBUILDING $ r�.,� VALUATION OF TOTAL CONSTRUCTION <br /> •�- c.n./.�'+� <br /> DELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> -l� Z C �r" <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION i � <br /> 1 <br /> OGAS [� ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER �/ '� 3� rf � <br /> COMPANY <br /> SIGNATURE ,�.REGISTERED Y/ N FEE CURRE� Y/N <br /> •� � <br /> Address 3 License# ���_,,�1p�"7'�� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <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 /> 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 fo�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 construcUon. <br /> Directions: <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 57500) <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 <br />