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s�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Depattment <br /> , � <br /> Date Received Phone Contact for Permitting ��v ', � � -S S�-{(o <br /> Owner's'Name I O'f� � '��S � � Owner Phone Number �� �3 " �� � ���-:�1 �I <br /> Owner's Address � O � Q \ � L � Owner Phone Number � <br /> Fee Simple Titleholder Name � Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS (�j d � , L`j ? < < �� '3'j S�I 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 7�' <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK \ �V"Cl�j (�l� CJY��°-+�1 11.Q,a,'1- C Q-✓1C f� ( <br /> BUILDING SIZE —� SQ FOOTAGE I� �� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> .��z��� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER n 1 COMPANY ���`-'� �G�S���-�� �t}� <br /> SIGNATURE �C ' REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �`�J G � `¢�( �� (.�C�� F� 3 3 l 3 License# C� C O�i'� �'� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y I 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 CURREA 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&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&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 /> 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 Appiication Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on publlc roadways..needs ROW <br />