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a�s-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received •� Phone Contact for Permfttin — <br /> Owner's Name � C,� � d� Owner Phone Number 0— J`% � <br /> Owner's Address � �i `"� h,h Ow�er Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��� � ' "1 LOT# � <br /> SUBDIVISION PARCEL ID!! <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR B ADD/ALT Q SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR � COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTION OF WORK �V�C" <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> OBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � „ � ' <br /> �%� �� !/� ..-_ � <br /> [�MECHANICAL $ /D ��� VALUATION OF MECHANICAL INSTALLATION� � ' <br /> �j � " � <br /> �`` ��,,.-.-:�..• <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <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 COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL ���Ui"'OC1 COMPANY (�( C <br /> SIGNATURE REGI TERED N EE CURRE� Y/N <br /> Address '✓ �l5 .— '� � S3f�"� License# �C �( ? � � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Fortns;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 Facilitles&1 dumpster;Site Work Permit for subdivisionsllarge 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 8 1 dumpster.Site Wo�ic 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 consVucGon. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Co�tractor sign back of applicatlon,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over 57500) <br /> " Agent(for the contractor)or Power of Attomey(for the owner)would be sameone with notarized letter f�om owner authorizing same <br /> OVER THE COUNTER PERMITTING (Frorit of Applicatlon Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW, <br />