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.�� '�/ � �f— ���� <br /> a�s-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> , Building Department <br /> , Date Received Phone ConWct for Permitting - <br /> ' � � � � � ��-� - - - - - - �-�r7 r <br /> � � ,/ <br /> Owners Name Owner Phone Number( <br /> Owners Address "1 1 Owner Phone Number <br /> Fee Simple Titleholder Name � Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS C � � I"1• FL 2 LOT# C� <br /> SUBDIVISION Un I L PARCEL ID# I Z� w r Z I � U ��/LMJ'�V� <br /> (OBTAINED 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 FR.4ME 0 STEEL Q � <br /> DESCRIPTION OF WORK � Wr L.1 � �� ' <br /> BUILDING SIZE SQ FOOTAGE C� HEIGHT �� \ <br /> �-r-r-r.�"�"�"r_ <br /> �BUILDING $ � /� �1,'1 VALUATION OF TOTAL CONSTRUCTION <br /> (J C/C! <br /> �ELECTRICAL ($� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �— <br /> �PLUMBING $ i//) . ��� <br /> v(/ �1 <br /> �MECHANICAL $ VALUATION OF MECHAN�CAL INSTALLATION <br /> �GAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AR�p �YES NO <br /> �9 <br /> BUILDER ��%/J� M ANY C S V�1�` <br /> SIGNATURE �� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Y V�• �Y �icense# I�VC�S�'1'J�2 <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGI ERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> ---�y.�� �' YI�r►�bin q Vn l�m�i-C oF <br /> PLUMBER T7 rI � ��� COMPANY <br /> SIGNATUR� � REGISTERED Y/ N EE CURRE� Y I N <br /> Address u �r � . P�'�' J��1e License# �G"`JS� J <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y J N FEE CURRE� V/N <br /> Address License# �� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y 1 N FEE CURRE� Y/N <br /> Address License# <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of BuOding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> M�nimum 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 subdivisio�sllarge pro�ects <br /> COMMERCIAL Attach(3)complete sets of Buildinp Plans plus a Life Safety Page;(1)set of Energy Fortns R-O-W Permil for new construction. <br /> Minimum ten(10)working days after submirial 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 Ariach(2)sets of Engineered Plans. <br /> ""PROPERTY SURVEY required for all NEW construdion. <br /> Directions:• <br /> Fill out application completely <br /> Owner&Contrador sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over b7500) <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 PERMITIING (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 />