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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> � Building Department <br /> Date Received <br /> ` Phone Contact for Permlttln _ <br /> Owner's Name v y � � <br /> Owner Phon mber ..2 — � <br /> Owner's Address � �p �- " /� �e�l <br /> /+�C /� Owner(�o 'Number 7� . '��y�.�� .� <br /> `�-...___._. ._____ <br /> Fee Simple Titleholder Name Owner Phone Number � ~+ <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ✓ � ��o �C /y r-� LOT# �] <br /> SUBDIVISION !I•" � � <br /> � PARCEL ID# �✓C7� -- � 6 -� %--rj G ! l� -boa o6 �-�S/al <br /> (OBTAIncu FROM FiiOPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 ADD/ALT � SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME [� STEEL Q <br /> DESCRIPTION OF WORK � � � � / <br /> /v <br /> BUILDING SIZE � X � U � SQ FOOTAGE�] <br /> HEIGHT �GbT <br /> �BUILDING $ <br /> lii $�'� � � � VAWATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLA �� <br /> TION � �, <br /> I' <br /> �GAS � ROOFING Q SPECIALTY <br /> � OTHER <br /> FINI9HED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER �� <br /> SIGNATURE r COMPANY �/� �� <br /> REGISTERED Y/ FEE CURRE� Y/N <br /> Add�ess ' License# �— � <br /> EIECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# �—� <br /> PLUMBER COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# �- <br /> MECHANICAL COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Llcense# —1 <br /> OTHER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> 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)working days after submittal date. Requlred 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 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 Work Permit for all new projects.All commercial requirements must meet compliance <br /> iIGN PERMIT Attach(2)sets of Engineered Plans. <br /> """PROPERTY SURVEY required for all NEW construction. <br />)irections: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,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 someone with notarized letter from owner authorizing same <br /> IVER THE COUNTER PERMITTfNG (Frorit of Application Only) � ' <br />',eroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />