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a�saso-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Depa�tment ( 1 <br /> „�,� ;1 <br /> Date Received 8 � phone Contact for Permittin 7 Z7 �t)�� — �/ � <br /> � � <br /> Owner's Name i � �.�i2c* �-'��'S� Owner Phone Number ��3 ������ <br /> Owner's Address ��� ��'»'"� �` � � ���'-� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ����r --rr-rrrr.c / LOT# �� <br /> SUBDIVISION ScJM/A�r�/��� , pARCEL ID# � ��� ' � � ' � �v�� � ��3 � �(�U <br /> (08TAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK G/v � Lr✓/��.��%��S . ac� <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT <br /> BUILDING $ /� .� (�'J VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ -� �� ��� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION Z � � <br /> QGAS Q ROOFING Q SPECtALTY 0 OTHER �' � ( "- <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER G >, �`����`' COMPANY �1�!!�T/� W�����'u� l�� <br /> SIGNATURE t�r- ��� REGISTERED Y/ N FEE CURRE� Y/N <br /> � <br /> Address ��1�( f �j.!' �t � � License# ��c � � �y�y <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPANY <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 /> OTHER � COMPANY <br /> SIGNATURE REGISTERED Y( N FEE CURRE� Y I N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fonns;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 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)warking days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence fnstalled, <br /> Sanitary Facilitles 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 consVucUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Appiication 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 />