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a�a-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Recaived Phone Contact for Permittln G _ �Q69 <br /> Owner's Name J�.�/1>Q�'l � '`'��L Owner Phone Number •��j(/ � � �} <br /> Owner's Address � '��lp � Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee 5imple Titleholder Addresa <br /> JOB ADDRESS �'1���Q , d �.(;��, , - � �j. S�-{ LOT# �� <br /> SUBDIVISION �� PARCEL ID# �' 1- ,3 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED e NEW CONSTR B ADD/ALT SIGN Q DEMOLISH <br /> INSTALL REPAIR �._ ��� <br /> PROPOSED USE � SFR � COMM OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK I � C� f E; � �(�[j � �S �� S eG'l 1�� � �i `� <br /> BUILDING SIZE �--� g(�FOOTAGE�� HEIGHT <br /> QBUILDING � n � ..-- VALUATION OF TOTAL CONSTRUCTION <br /> .� <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> �PLUMBING $ <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> /��3� 1 <br /> QGAS ,�' ROOFING Q SPECIALTY 0 OTHER � <br /> f��7 <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO ( <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N fEE CURRE� Y/N <br /> Address License# r- -� <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 Q(�1(�!' <br /> SIGNATURE REGISTERED Y/ N FEE CU n Y/N <br /> Address � � f� � License# �_ <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Bullding Plans;(1)set of Energy Forms;R-O-W Pertnit for new construc6on, <br /> Minimum ten(10)woiicing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities&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 Faciiities&1 dumpster.Site Work Permft 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 construcUon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,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 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 />