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i <br /> 813-780-0020 City of Zephyrhills Permit Application � ��� 1•�•��' Fax-813-780-0021 <br /> Building Department ..- <br /> i ��A <br /> Date Received �r Phone Contact f r Permitting �l.� d'�G -- ..3.ZG•-- �-�- "�J <br /> Owner's Name i � /q, Owner Phone Number <br /> . <br /> Owner's Address Z�("1�� Owner Phone Number[ <br /> Fee Simple Titleholder Name Owner Phone Number[ <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS S� 'yZ �,3,�, �. � LOT# � <br /> SUBDIVISION (. / O� Z' /�S, PARCEL ID# /�".2(�:Z/— (,YJ�6� �'I�OD'�d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR e ADD/ALT Q SIGN Q MrJVE � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR � COMM Q OTHER � <br /> TYPE OF CONSTRUCTION � BLOCK � FRAME Q STEEL Q O'fHER <br /> DESCRIPTION OF WORK �C� ,a� Ct �p� X C�F �,S ,'�7y: .3G <br /> BUILDING SIZE �� SQ FOOTAGE HEIGHT <br /> � BUI�DING <br /> $ /''��Q — VALUATION OF TOTAL CONSTRUCTION <br /> � ELECTRICAL $ � AMP SERVICE � PROGRES:i ENERGY � W.R.E.0 <br /> � PLUMBING $ � ��„!� <br /> � `f <br /> 0 MECHANICAL $ � VALUATION OF MECHANICAL INSTALLATION <br /> � GAS � ROOFING 0 SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES ��NO <br /> BUILDER � ���� ROMP RNY� �-G.�i� �v�i'"EN� Y/��S . <br /> SIGNATURE <br /> Address J! ,3•2 . � e� Y � License# .���7�y <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# � <br /> PLUMBER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CUf2RENT Y/N <br /> Address License# � <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CUI�RENT Y/N <br /> Address License# � <br /> OTHER COMPANY � <br /> SIGNATURE REGISTERED Y/ N FEE CURRENT Y/N <br /> Address License# <br /> RESID�NTIAL 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)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans pius a Life Safety Page;(1)set of Energy Forms.R-O-V�!Permit for new construction. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,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 required for all NEW construction. <br /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) <br /> ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />