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8�3-780-Q02Q City of Zephyrhills Permit Application Fax-813-780-0021 <br /> • Building Department <br /> Date Received , �_ l� ��� <br /> Phone Contact for Permittin <br /> i / <br /> Owner's Name ('i1�Li,Q.I Owner Phone Number d��> /(0�7��6U <br /> Owner's Address .C.f. �l`�� G Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS l� / �° �` l� ,Q �'��(�/ S LOT# �� <br /> SUBDIVISION PARCEL ID# O2—2CD°� —�d�U — GLr�b�-�='/30 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSEO e NEW CONS7R 8 ADD/ALT �� SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK a r D 7T !�!�-1/'1 —�$�7� s �'►C�jQ <br /> BUILDING SIZE �--� gq FOOTAGE � HEIGHT I Sfi <br /> ��BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> � �0 <br /> QELECTRICAL $ � AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING � SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA [�YES 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 COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER �� �/��� � r� COMPANY �r�a/?C�Z �o � u iUn���,C <br /> SIGNATURE ��2�"'W i��F°`°'/ �'" ` REGISTERED Y! N FEE CURRE� Y I N <br /> Address �� � / KGI' Lt �S�P� License# ��� l3�! �7� <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)working days after submittal date. Requfred onsite,Construction Plans.Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 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 construcHon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compiiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "*"'PROPERTY SURVEY required for all NEW constructlon. <br /> Directions: <br /> Fill out appiication comptetely � <br /> Owner&Contractor sign back of application,notarized <br /> If over E2500,a Notice of Commencement is required. (AIC upgrades over 57500) <br /> "` Agent(for the contractor)or Power of Attorney(for the owner)wouid be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMITTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoVSurvey/Footage) <br /> Driveways-Not over Counter if on publ(c roadways..needs ROW <br />