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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � Phone Contact for Permittin �1� ��� - �� � <br /> Owner's Name �I-r 1�� � �� �-�- Owner Phone Number ��� 7��-' �_ � <br /> Owner's Address l'��i� �`� Nv� '3C1 �QF�,1 �. Owner Phone Number <br /> Fee Simple Titleholder Name ��'' ��- Owner Phone Number C <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS C�CG ��u--��-�'� �P I'� R-��� LOT# � <br /> SUBDIVISION Z� CN��+1 C�K�VtN � , PARCELID# d�'��'`�G---� '�� `��ZC'� ' OG1�i � <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT 0 SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q C <br /> DESCRIPTION OF WORK OPc►�itS� �T ►�'�C� �a(.tiSTil�Cy- 1�-1�'t0 a�R.t�- \I.I�t`cRa�O'� W��I-I-� <br /> BUILDING SIZE ��X�� N1�►- SQ FOOTAGE '+�1�1 HEIGHT ��� <br /> �BUILDING $ ` ��C�,�� VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ �� AMP SERVICE �C�ST�KIr I �' PROGRESS ENERGY � W.R.E.C. <br /> `7'�^� <br /> QPLUMBING $ N R � ?, j�� <br /> � ( J <br /> QMECHANICAL $ �� VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES �Q <br /> �X�S�t�- - <br /> BUILDER ____ ____ COMPANY �y��C'��'��h��d� �� t�� <br /> SIGNATURE - � _ �Y � REGISTERED Y! N FEE CURRE� Y/N <br /> �_=s ---.. <br /> Address ��c:�� �� � �pFl (�.�11i-l;j . License# r�"�-� 15��'7��7 t�.- <br /> ELECTRICIAN � ��\ � � COMPANY N�� <br /> SIGNATURE �V REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �- � <br /> PLUMBER � A COMPANY x� <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 /> SIGNATURE �� COMPANY �A' <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r- <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimurri ten(10)woricing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Wor1c Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans pius 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,Construc6on 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 construction. � � <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Natice 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 fr m. �...,�.. <br /> .n. . �' y'� � <br /> OVER THE COUNTER PERMITTING (Front of ApplicaBo„�Only) > ,,h,, " _, ' <br /> Reroofs if shingles r�""'`Setvlce Upgrades A/C ences(PIoUSurvey/Footage) ? ��• ;, ,�.; , „ � f,� ,��'�,! : <br /> i� % * .� . '� l <br /> Driveways-Not br Counte1`l�on�pLblic roadways:.ne�ds R , � ' ' ��_.�%` <br /> ` � ..,�. F'crJ4'�b, , ..c „ .' � <br /> . �S„; , i . :i, ' ,. . <br /> ,z ..L'; .'rM � � ...•.r�x.� . <br />