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a�3-�eo-oozo City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Receive� <br /> ` Phone Contact for Permittin <br /> � f I 1 � <br /> Owner's Name < <'v�w�( t Owner Phone Number S� ?" -7�!�- �;c�j�7 <br /> t t �Owner's Address .� `-� �� ;f� �` `�� Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number �— <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ...J �%� �LI � �''� .5'7" LOT# C� <br /> SUBDIVISION PARCEL ID# ��` �� �-1 -C(,�/�-��fQi1�-(�`yC <br /> (OBTAINED F�PROPERTY T�TicE)DEMOLISH <br /> WORK PROPOSED e NEW CONSTR 8 ADD/ALT �� SIGN <br /> INSTALL REPAIR <br /> PROPOSED USE [� SFR Q COMM [� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK � FRAME � STEEI Q <br /> DESCRIPTION OF WORK �' / ���L � ;�S <br /> Lr� <br /> BUILDING SIZE .8A�FOOTAGE I.5 � HEIGHT <br /> OBUILDING $�y��,/ �� VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION ( ' � ��� � <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO <br /> BUILDER /' � „'�� . � COMPANY ('fyl( lY- '✓f[:z <br /> SIGNATURE � REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �� ��c!� (p,� Ls7j 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 COMPANY <br /> 31GNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 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 submfttal date. Required onsite,Constructlon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpster;Site Work Permit for subdivisionsllarge 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 constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence Installed, <br /> Sanitary FaciliUes 8�1 dumpster.Site Wor1c 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 consUuction. <br /> Directions: <br /> Fill out application completely. <br /> Owner 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 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 />