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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received �,,/� ��� ` ���.0 <br /> Phone Contact for Permittln <br /> Owner's Name iVGiY�C �Qy� �d Owner Phone Number 8� 3- 3-�ac�� <br /> Owner's Address '�j y 3 O �lR`�� c7�'+ Owner Phone Number �— � <br /> Fee Simple Titleho�der Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS ��I�d 1 (� �c• LOT# � <br /> SUBDIVISION , PARCEL ID# �` a�-�' a l CX�1 O ��(7(� �(�d <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR� 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 DuC'C` �R�,��CEMCN't— U 1up�l2 �U�� <br /> BUILDING SIZE � SQ FOOTAGE�� HEIGHT <br /> [�]BUILDING � VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> � I l 1 �� <br /> �IECHANICAL $ 1��B VALUATION OF MECHANICAL INSTALLATION <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 �IR �2 C I(1 `j{'� j� S o�"�CIS�G �l�C.. <br /> SIGNATURE REGISTERED N FEE CURRE� N <br /> address `��O �Cik 1 a-3 License# �QG l�S�S�-1�� � <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address Ucense# <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 /> Sa�itary Facilities 8 1 dumpster;Site Work Pennit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safery 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& 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 conshucUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over Sz500,a Notice of Commencement is requi�ed. (A/C upgrades over 57500) <br />"' Agent(for the conU2ctor)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 />