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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0 21 <br /> Building Department <br /> Date Recelved �� ' � �'� <br /> TR '_ Phone Contact for Permlttin �� <br /> Owner'sName � � S S �' r,rs ,* Dl�w��a' <br /> � Owner Phone Number a S <br /> Ow�er's Address 324�?3 � <br /> Owner Phone Number <br /> Fee Slmple TlUeholder Name ,�f <br /> Owner Phone Number <br /> Fee Simple Tltleholder Address �1/ .�' <br /> JOB ADDRESS 3�$ Q <br /> LOT# <br /> SUBDIVISION � � PARCEL ID# �' •�` � ('Q. $ 1 <br /> B (OBTAINED PROM PROPERTY TA%NOTICE) ' <br /> WORK PROPOSED NEW CONSTR ADD/ALT �� SIGN <br /> INSTALL 8 REPAIR � 0 DEMOLISH <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FR,4ME �� STEEL Q <br /> DESCRIPTION OF WORK �� ��� ' �� • <br /> BUILDING SIZE SQ FOOTAGE HEIGHT �.� <br /> QBUILDING $ � •O <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL �� AMP SERVICE � PROGRESS ENERGY � W.R.E. �l�1�l/ <br /> f <br /> �PLUMBING $ <br /> QMECHANICAL S VALUATION OF MECHANICAL INSTALLATI Pl�� �����^�� ' <br /> OGAS Q ROOFING Q SPECIALTY '� �' <br /> � OTHER � ' � ��/ � � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREq �YES NO �i-i ' <br /> BUILDER � COMPANY <br /> SIGNATURE � � <br /> REGIS7ERED Y/ N E CURREA y(�.J <br /> Address License# �� ,�7� <br /> ELECTRICIAN (\ � � COMPANY Q!Q � � L� <br /> SIGNATURE ��/� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address d Z Z ��� License# bt�� ��53 <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N E CURREA Y/N I <br /> Address (f <br /> I----� License# <br /> MECHANICAL I � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y 1 N <br /> Address License# <br /> OTHER V COMPANY '[,—/¢�i.t���n,,L ry` <br /> SIGNATURE REGISTERED Y/ N FEE CURREA Y/N <br /> Address �i�i i•[ � {�/ �r�.-1 License# �(� a Z� <br /> IIIlillltllllllllllllllllllllllllllllllllllllllllllllllllllllllllll <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(t)set of Energy Forms;R-O-W Permil for new construction, <br /> Minimum ten(10)working days after submillal dale. Required onsite,ConsUuctlon Plans,Stormwater Plans w/Silt Fence install d, <br /> Sanitary Faalities 8 1 dumpster;Sile Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Enerqy Forms.R-O-W Permit for new construction. <br /> Minimum ten(10)workinp days after submittal date. Required onsite,Conslructlon Plans,Stormwater Plans w/Silt Fence install d, <br /> Sanitary Facilities�1 dumpstar Sile Work Permit for all new projects.All commercial requiremenis must meet comp�iance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY requlred for all NEW constructlon. <br /> Dlrectlons: <br /> Fill out application completely <br /> Owner&Contractor sign back of appliptlon,notarized <br /> If over 52500,a NoUce of Commencement is requlred. (A/C upgrades over 57500) <br /> " Agenl(for the coNractor)or Power of Attorney(for the owner)would be someone with notarized letler irom owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> R�rocrc if shlrg;e.s Sewers Service Up^,�ad�s .A/C F�nces(PIeUSurveyiFonta��r) <br /> Drlveways-NOl over Counter if on public roadways..needs ROW <br />