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a�s-�$o-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received ��23�v phone Contact for Permittin — <br /> Owner's Name .�.! Owner Phone Number 7/�D.. �9 7-- �r <br /> Owner's Address � �' e e Owner Phone Number � <br /> Fee Simple Titleholder Name �— Owner Phone Number � <br /> Fee Simple Titleholder Address � <br /> JOB ADDRESS I �T� S�ET LOT# � <br /> SUBDIVISION �'/SO yU PARCEL ID#�— a�p —a��-nl�/3 � QQ,�U — O!O� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT Q SIGN Q �] DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER �V <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK { q ;ti � w; Tj $ ' <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT � � <br /> QBUILDING $ � � VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ !,�j� � <br /> � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � � COMPANY QA v i d �iJ ..�o l�rv So N BV�L�iRS 1 �/C�' <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �o ;.. p� License# [,[�L Q(� (3 3/�p � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address license# C <br /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Buflding Plans;(1)set of Energy Fortns;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 Facflities 8 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 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&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A!C upgrades over 57500) <br /> "• Agent(for the contractor)or Po�ver of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTIN� (Front of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/SurveyfFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />