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813-780-0020 City of Zephyrhilis Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received � <br /> Phone Contact for Permitting _ <br /> Owner's Name �' S <br /> Owner Phone Number - <br /> Owner's Address `J��wner Phone Number � - �]� <br /> Fee Simple Titleholder Name Owner Phone Number <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � � LOT# � <br /> SUBDIVISION , PARCEL ID# - <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADDlALT � SIGN Q Q DEMOLISH <br /> INSTALL 8 REPAIR <br /> PROPOSED USE � SFR � COMM �� OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME �,� STEEL � <br /> DESCRIPTION OF WORK � �2 <br /> BUILDING SIZE � Y 2n SQ FOOTAGE� I HEIGHT <br /> — —J <br /> �BUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY <br /> 0 W.R.E.C. <br /> OPLUMBING $ � <br /> MECHANICAL �� `� � <br /> 0 $ VALUATION OF MECHANICAL INSTALLATION �� � <br /> [�GAS � ROOFING � SPECIALTY � [��j <br /> � OTHER � _/�7 <br /> FINISHED FLOOR ELEVATIONS �I� <br /> FLOOD ZONE AREA DYES NO "� <br /> �+���� <br /> BUILDER CO PANY <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 <br /> 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)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 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&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 /> Directions: <br /> Fill out application completely <br /> Owner&Contractor sign back of application,notarized Z� ��� <br /> If over$2500,a Notice of Commencement is required. (A/C upgrades over 57500) �A7 � <br /> "* Agent(for the contractor)or Power of Attomey(for the owner)would be someone with notarized letter from o r authorizing sam <br /> OVER THE COUNTER PERMITTING (Front of Application Only) � �� <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) , , <br /> �.�:�"'"N'`. PE6GY ANN BRACKNEII <br /> Driveways-Not over Counter if on public roadways..needs ROW ? �'�= Notary PuDNc-St�te ol Florida <br /> ;�, o.,: My Comm.Expka Ju122.2015 <br /> �'•:'F��,�:.•' Commlaafon#�EE 00500 <br />