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ais-�eo-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received phone Contact for Permitting � _ � <br /> � � 1 7 1 1 1 �- - - - - - -1-t �-1-1 -- <br /> Owners Name /� G Owner Phone Number -Ol � ���• �� <br /> Owners Address Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 39 a 3 � LOT# �� <br /> SUBDIVISION SWI�iLV� C.���� PARCELID# ��'-d�Q�a� � O3D ��� �� SV <br /> �OBTAINED FROM PROPERTV TAl(NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIC�N O � DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE Of CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK �Y.3 • �' <br /> BUILDING SIZE S�FOOTAGE HEIGHT �. � <br /> �BUILDING $ C ��� D VALUATION OF TOTAL CONSTRUCTION <br /> J <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ �G-� <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION '� � �� t�� <br /> �GAS Q ROOFING Q SPECIA�TY O OTHER �� <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE C en Y/N <br /> 1 ' ' F 33S / s�1 <br /> Address License# ��L V �,� <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address <br /> License# <br /> PLUMBER � COMPANY �- <br /> SIGNATURE REGISTERED Y( N FEE CURRE� Y/N <br /> Address <br /> License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE REGISiERE� Y! N FEE CURRE� Y/N <br /> Address <br /> License# -� <br /> Illlllllllllllllllllllllllllllllllllllllllllllllllllllllllllliillll <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,S[ortnwa[er Plans w/Silt Fence installed, <br /> Sanitary Facilities&t dumps[er;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 Fortns.R-O-W Pertnit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stortnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster Site Work Permit for all new projects.All commercial requirements must meel compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "'•PROPERTV SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applica[ion,nolarized <br /> If over 52500,a Notiee of Commencement is required. (AIC upgrades over 57500) <br /> " Agent(for ihe contractor)or Power of Attomey(for[he owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Applica�ion Only) <br /> Reroofs if shingles Sewers Service Upgrades A!C Fences(PIOVSurveylFootage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />