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a,s-�ao-ouzo City of Zephyrhills Permit Application � Fax-813-780-0021 <br /> Building Department �/3 j�'� <br /> Date Received � 'l - 'Z- phone Contact for Permittin -- <br /> Owner's Name �P�7(' e � nn� �Q� Owner Phone Number ��°3 (,9 ' �� ��f <br /> Owner's Address �� a3 \ �O e� e. Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee 3imple Titieholder Addresa <br /> JOB ADDRESS 3S 3 �t�d�`�w-c c' A�tl� t' `(� �''�'1 a`�s �I a�. �5 �Z LOT# � <br /> SUBDIVISION PARCEL ID* v ' � a� ' � jo,0 - O 0�p O — C�O �p <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> 1MORK PROPOSED B NEW CONSTR e ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK =.�st-�1�� ' W � ��c�o w S �J <br /> BUILDING SIZE SQ FOOTA(iE� HEI(iHT <br /> UILDING S i( �� � VALUATION OF TOTAL CONSTRUCTION <br /> �.J <br /> QELECTRICAL a AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING � <br /> QMECHANICAL s VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER � COMPANY �P/� <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> PLUMBER COMPAMf <br /> SIGNATURE REGISTERED Y/ N FEE CURREP Y/N <br /> Addresa License# <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r— <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y!N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Pla�s;(2)sets of Building Plans;(1)set of Energy Fortns;R-O-W Permit for new construction, <br /> Minimum te�(10)working days after submittal date. Requfred onsite,ConstrucGon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlides 8 1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL AtNach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permtt for new construction. <br /> Minimum ten(10)working days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Sflt Fence installed, <br /> Sanitary Facilitfes 8 1 dumpster.Site Work Permit for all new proJects.Ail commercial requirements must meet compliance <br /> 31GN PERMIT Attach(2)sets of Engineered Plans. <br /> "•"PROPERTY SURVEY required for all NEW constructlon. <br /> Directlona: <br /> Fill out applicatfon completely. <br /> Owner 8 Co�lractor sign back of appl(cadon,nota�ized <br /> If over 52500,a Notice of Commencement is roqufred. (AIC upgradea over=7500) <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 Applicatlon Only) . � <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Drivewaya-Not over Counter if on public roadways..needs ROW <br />