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a�s-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permittin <br /> Owner's Name � Y^ �13-�g g -3og3 <br /> Owner Phone Number <br /> Owner's Address :J �� � �"� �, t Owner Phone Number <br /> Fee Simple Titleholde�Name � � <br /> Owner Phone Number <br /> Fee Simple Titlehoider Address <br /> JOB ADDRESS J O��-�") � �- ,(- ,;—1 <br /> LOT# i�-1--L--.J <br /> SUBDIVISION �I �e Q � PARCEL ID# O� �a c�a -o���-��-�,�_���� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT � SIGN <br /> � INSTALL B REPAIR 0 � DEMOLISH <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � <br /> DESCRIPTION OF WORK C C (� �u(,�' � � -r}�l,l,(�I� <br /> �i <br /> BUILDING SIZE SQ FOOTAGE� <br /> HEIGHT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> [�ELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY <br /> Q W.R.E.C. <br /> OPLUMBING $ <br /> �IECHANICAL $ ���� VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> QYES NO <br /> BUILDER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> ELECTRICIAN 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 <br /> License# �— <br /> MECHANICAL COMPANY �`a(1 V 1'�'S �(,�(� ' �-�(}�,ciy�. <br /> 51GNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address , �Z' U� 1 ' Z �j3� License# �-- � � � <br />�THER <br /> iIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � <br /> License# <br /> tESIDENTIAL 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&1 dumpster;Site Work Permit for subdivisions/large projects <br />:OMMERCIAL 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 /> IGN PERMIT Attach(2)sets of Engineered Plans. <br /> "*"PROPERTY SURVEY required for all NEW construction. <br /> irections: <br /> Fill out application completely. <br /> Ovmer&Contractor sign back of application,notarized <br /> If over s2500,a Notice of Commencement is required. (A/C upgrades over aT500) <br /> Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from owner authorizing same <br />✓ER THE COUNTER PERMITTING (Front of Application Oniy) <br />:roofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadwaus..needs ROW , <br /> � . . . <br />