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$1a-�so-oo2o City of Zephyrhills Permit Application Fax-813-760-0021 <br /> Building Department <br /> Date Received '- / � Phone Contact for Permittin �'.SL. - ��j� <br /> Owner's Name �� S �C L � ` -+ � '� <br /> Qwner Phone Numt� � 3 .� <br /> L--_—,__ _' .�.__. <br /> Owner's Address ��� Q (�{' �� � �'►��rner Phone Number <br /> 3?,S`IZ <br /> Fee Simple Titleholder Name �— Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � 1 � � �Te�b�rr �Q �c(� �L, 3�s LOT# � <br /> SUBDIVISION �Q����1p�- ��y�d(' PARCEL ID# , d ��D °� � C�� Z� OOOOC3 4 � gO <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> VIIORK PROPOSED e NEW CONSTR 8 ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE�F CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK � (' l � � <br /> BUILDING SIZE � SQ FOOTAGE ,,� HEIGHT <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION SS2� •� <br /> DELECTRICAL $ AMP SERVICE � PROGRESS ENERGY [� W.R.E.0 <br /> OPLUMBING $ ��✓ ' �'� � t�t �(J�„ <br /> /� • <br /> � ,e.. ._ _ <br /> C:.�_�_.__ i . --- <br /> �MECHANICAL $ VALUATION OF MECHANICAL�ISTALLATION ' , j�(�r�--=-`� <br /> � - __.... ('�:� �� <br /> OGAS � ROOFING Q SPECIALTY 0 OTHER 1 <br /> i <br /> FINISNED 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 SC `"� COMPANY S�-�������^-�U'C � <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address �� ��- I (�$ �,�1U�. � �1b License# C...�._� J��� <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. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivislons/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 Facflities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Phans. <br /> ""'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over E7500) <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 Application 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 />