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s�a-�ao-oo2o City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin ✓'r� � ���i S _ �-� �/ <br /> Owner's Name � J c /.1 r' � �'1.t�-� Owner Phone Number ��� � y� 3 �� y�/ <br /> Owner's Address % ��3`� � �� S/ Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number �— —� <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �', C\ � � � � ' � � LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CoNSTR 8 ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME 0 STEEL Q <br /> DESCRIPTION OF WORK <br /> BUILDING SIZE r SQ FOOTAGE C� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING � <br /> , $ , C� �--� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY �] OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> -- - - � ) <br /> PLUMBER ' `� � COMPANY � �'�//VQ-�s-_- <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 COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Addreas License# �— � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bufiding 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 Pians w/Silt Fence installed, <br /> Sanitary FaciNties 8 1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Building Pians plus a Life Safety Page;(1)set of Energy Fonns.R-O-W Permit for new construction. <br /> Minimum ten(10)working days aiter submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence insta�led, <br /> Sanitary Facilities�1 dumpster.Site Work Permit for ali new projects.All commerciai requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '"*"PROPERTY SURVEY required for all NEW consVuction. <br /> Directions: <br /> Fill out application compietely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requlred. (AIC upgrades over s7500) <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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />