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s�a-�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 1 � t �A � Owner Pho�e Number �3 � 7 1 r J 7 Z <br /> � �l3 � -� - % � � <br /> Owner's Address � S �3 c�- � Lct �� ^ ' l, Owner Phone Number J � <br /> y S 4f <br /> Fee Simpie Titlehoide�Name Owner Phone Number <br /> Fee Simple Titleholder Address ��D�3� 3�'��y i ��j�t/ � 3,�j��S`�j <br /> JOB ADDRESS "" 3�'��� , � � ,�� ��/� I�, LOT# � <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEw CoNSTR B ADD/ALT �� SIGN [� Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK - � y�i '� 31��l� l./yt P �q,,�-- Q ` <br /> BUILDING SIZE SQ FOOTAGE 7 O���(�' ����HEIGHT �iy / <br /> OBUILDING $ VALUATION OF TOTAL CONSTRl1CTION � `>� �•� ,' <br /> \ / . <br /> QELECTRICAL $ AMP SERVICE �_ P�RE�S ENERGY [� W.R.E.0 <br /> OPLUMBING $ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY [� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> � t ,� -' <br /> BUILDER COMPANY <br /> SIGNATURE J`,� � i1 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 COMPANY <br /> SIGNATURE REGISTEREO Y J 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 submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivlsionsAarge 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 constructian. <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 /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> ""'PROPERTY SURVEY requ(red for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over E2500,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 />