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s�s-�ea-oa2o� City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � � /3 � ` � <br /> Phone Contact for Permittin <br /> Owner's Na�ne • � �"-�t"— Owner Phone Number <br /> `�- � j.. <br /> Owner's Address J� � �� r �� �M_ Ow�er Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS 3� i � �•�- r� � �.� � <br /> LOT# <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR ADDlALT � SIGN � � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE SFR COMM �� OTHER <br /> TYPE OF CONSTRUCTION � BLOCK � Q FRAME C� STEEL <br /> 0 <br /> DESCRIPTION OF WORK C ��-1-P� �I/✓� ���R.n �'��� <br /> v� � <br /> BUILDING SIZE SQ FOOTAGE C� HEIGHT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> B,MECHANICAL $ , p��� VALUATION OF MECHANICAL INSTALLATION <br /> M'f <br /> OGAS Q ROOFING Q 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 <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r <br /> MECHANICAL � ���� COMPANY 'b� T�.�''1 f#f �.�t,�,T� ' <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 /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construc�on Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilitles&1 dumpster;Site Work Permit for subdivlstons/large projects <br /> COMMERCIAL Attach(3)complete sets of Buflding Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construcUon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilides&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 /> T,-r,7-rTT���:.'ii i�..dJ..� <br /> 1 I1711�111�11111177�11�1■ <br /> Directions "' <br /> Fill out application completely. <br /> Ovmer 8 Contractor sign back of application,notarized <br /> If over E2500,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 /> OVER THE COUNTER PERMiTTING (Front of Apptication Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />