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� a�s-�ao-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittln ��� 7 8Z —SO/ <br /> Owner's Name �� S �Q ` � Owner Phone Number 7' y/ --9 l <br /> Owner's Address � � � /[ -5 / � Owner Phone Number �— � <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> J08 ADDRESS $ i S � LOT# � <br /> SUBDIVISION , PARCEL 10# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP05ED e NEW CONSTR 8 ADD/ALT 0 SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME C� STEEL Q <br /> DESCRIPTION OF WORK � '� /C. � Di7/ ,,�TL3 <br /> BUILDING SIZE SQ FOOTAGE�� HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ � ^ <br /> MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION I <br /> �� /J <br /> 73� <br /> OGAS 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 ' 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 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)worlcing days after submittal date. Requlred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/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 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 required for all NEW construction. <br /> 11T�rl�f�rr�������r�i���e��� <br /> i �aia���a.�.i�1�i11 1 L7 1 J.Lli 1 1 <br /> Directions. <br /> Fill out application completely <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$250U,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 PERMIT7'ING (Front of Application Only) <br /> Reroofs if shingles 5ewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roaduvays..needs ROW <br />