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s�s-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department /� <br /> � <br /> Date Received ' -(Q-� Z <br /> Phone Contact for Pennittin ._ <br /> Owner's Name G. a Owner Phone Number �"?�s D/�� <br /> Owners Address ,�I..L � Q �� �,l � <br /> Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Numbar <br /> Fee 3imple Titleholder Addresa <br /> 3 �1 � D <br /> JOB AD�RESS LOT� �7`� <br /> SUBDIVISION Ti�c- � e�l�✓�at.c� PARCEL 10� a-y-o� -�/-QD�D- dG�')- a9�D <br /> �IDr f (08TAINED FROM PROPERTY T/UC NOTICE) <br /> WORK PROP03ED NEW CONSTR ADD/ALT C� SIGN Q Q DEMOIISH <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 < �/L(L(. GI� / , <br /> BUILDING SIZE �bt-X �OZ- SQ FOOTAGE SOS� HEIGHT <br /> �BUILDING a 3 SG� °o VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ OU AMP SERVICE Q PROGRESS ENERGY �] W.R.E.C. <br /> 3dd. �S� <br /> OPLUMBING a 1�I � � <br /> �� <br /> �]MECHANICAL a VALUATION OF MECHANICAL INSTALLATION � yP,��l a"n <br /> �]GAS �] ROOFING Q SPECIALTY 11',� _�L <br /> [_] OTHER �r�� � e��f� � <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO j�t� �a t'G r� <br /> I" <br /> BUILDER x ��� COMPANY ��� <br /> SIGNATURE �" �� REGISTERED Y/ N FEE CURREA Y/N <br /> Address ��dl� /'y� .Q/�' . Z- f . <br /> License# <br /> �"` ` <br /> EIECTRICIAN k 1 ,�� COMPANY 1�(V�� <br /> SIGNATURE ` l I � REGISTERED Y/ N fEE CURRE� Y/N <br /> Address �ya� /y .�I�. G � � � 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/N <br /> Addreas License# <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)woiicing days aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instalied, <br /> Sanitary Fadlitles 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 construcrion. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Pians,Stormwater Pians 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 requlred for all NEW constructlon. <br /> - -�.����������.����..�.�.�. <br /> Directions ""' <br /> Fill out applicatlon completely. <br /> Owner 8 Contractor sign back of applicaUon,notarized <br /> It over 52500,a Notice of Commencement(s requtrod. (AIC upgrades 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 Oniy) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />