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_ �'A�D�,G 1 1 0 <br /> sis-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department � ' � <br /> ���� � 'I''7`� .._�,z 5%'l" <br /> Date Received � �I v , , { 4 <br /> � � � � � � � � Phone Contact for Permitting __ <br /> 1 1 1 i 1 <br /> Owner's Name S \Y�" QGS Owner Phone Number ��`'gZ°�— rJ°�,(ps <br /> Owner's Address ���G �,r P W � <br /> !e S Owner Phone Number <br /> Fee Simple Titleholder Name �,/ a Owner Phone Number C � <br /> Fee Simple Titleholder Address K��t <br /> JOBADDRESS �jSI�2,'Z HGy�Y� �Y', LOT# � <br /> SUBDIVISION PARCEL ID# ��'�Z�'�Z�'���'-db�0.00�- DO`]� <br /> �OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR ADD/ALT � SIGN � � DEMOLISH <br /> INSTALL B REPAIR <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK �G�«-Ohn v j ti,�,,Gr,.�. � �,.�� ,y YGp�^,GG G�c -� 1 <br /> Y1 G S <br /> BUILDING SIZE SQ FOOTAGE 3S HEIGHT <br /> TT9TP9T1"7'T�T <br /> �BUILDING $ �� 000 VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W.R.E.0 <br /> OPLUMBING $ <br /> MECHANICAL / '�� <br /> 0 $ VALUATION OF MECHANICAL INSTALLATION �` � <br /> �GAS � ROOFING � SPECIALTY <br /> � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> �-4-����••�� <br /> BUILDER �i Q!V COMPANY _�cJ- `F � a <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Ad d ress \ <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �— <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y!N <br /> Address <br /> License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Ad d ress <br /> License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot P�ans,(2?sets of Building Plar.s;(1)set of Energy Forms;R-O-W Perm it 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& 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&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 /> �: ■ ^ <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$7500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways needs ROW <br />