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s�3-��o-oazo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received i� � Phone Contact for Permitting �(3 � _ <br /> Owner's Name �r r� Owner Phone Number �� a <br /> Owner's Address ��� t p�,� �', ��' �4ner Phone Number <br /> Fee Simple Titlehoider Name Owner Phone Number[ � <br /> Fee Simpie Titleholder Address <br /> JOB ADDRESS 55y l � 1����r h,11 S �� ���j�ip�,� LOT# �� <br /> SUBDIVISION PARCELID# '�—eZIQ'�o�,,���U'",� ��-�- b�� �� <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR B ADD/ALT Q SIGN 0 MOVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR �� COMM Q OTNER � <br /> TYPE OF CONSTRUCTI�N � BLOCK � FRAME � STEEL � OTHER <br /> DESCRIPTION OF WORK �v� ����-_� r1��y(� C.••.SCj� ,�j'�P 2 Z� <br /> BUILDING SIZE SQ FOOTAGE HEIGHT <br /> 0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL � AMP SERVICE � PROGRESS ENERGY � W.R.E.C. <br /> 0 PLUMBING $ � ���!�f C� <br /> 1 l, ( <br /> � MECHANICAL $ G�•(�_� � VALUATION OF MECHANICAL INSTALLATION ��j <br /> �. J r._-� �� <br /> � GAS � ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA OYES [�NO <br /> BUILDER COMPANY �— <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address Llcense# <br /> ELECTRICIAN COMPANY —� <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRENT Y/N <br /> Address License# � —� <br /> MECHANICAL COMPANY ��1��C,� ��{ �'1L- <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y!N <br /> Address 3 �y ,�� �/�• � � 3 y License# �C��R�� 1�(.(�I <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> RESID�NTIAL 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 L1fe Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. <br /> Minirri�m 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 8 Contracior sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (AIC upgrades over$5000) <br /> " Agent(for Ihe contractor)or Power of Attorney(for the owner)would be someone with notarized lelter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />