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�''�-'�0-0°20 City of Zephyrhills Permit A lication <br /> Pp Fax-s13-780-0021 <br /> Building Department <br /> Date Received <br /> Phone Contact for Permitting _ <br /> Owner's Name �Qf1 � �-�-� � <br /> Owner Phone Number ��3" �8�� <br /> Owner's Address v$p�� �p?� Je Ow�er Phone Number <br /> Fee Simple Titleholder Name <br /> Owner Phone Number <br /> Fee Simple Titleholder Address <br /> J08 ADDRESS 3��� �p7�h U� ��o � <br /> LOT# � <br /> SUBDIVISION , PARCEL ID# �f 'a "�I `d 6��� O �- O�� <br /> e (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN <br /> INSTALL 8 REPAIR 0 C� DEMOLISH <br /> PROPOSED USE � SFR � COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME C� STEEL � <br /> DESCRIPTION OF WORK � C� �, � , Q � <br /> BUILDING SIZE SQ FOOTAGEC] <br /> HEIGHT <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE <br /> � PROGRESS ENERGY Q W,R.E.C. <br /> QPLUMBING $ � . <br /> ' `'�3 � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INS � <br /> � Q� TALUTI�N <br /> �GAS Q ROOFING Q SPECIALTY �� OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA <br /> QYES NO <br /> BUILDER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address � <br /> License# <br /> ELECTRICIAN COMPANY <br /> SIGNATURE <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# � <br /> PLUMBER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> License# <br /> MECHANI AL COMPANY " �' Y/tl <br /> SIGNATUR �. -' Kl <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address '�h � � ,�'J1�,^ <br /> "a-f�°` License# ' <br /> OTHER <br /> SIGNATURE COMPANY <br /> REGISTERED Y/ N FEE CURRE� Y/N <br /> Address <br /> 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 FaciBties 8 1 dumpster;Site Work Permit 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 construcdon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Ptans w/Silt Fence installed, <br /> Sanitary Facili8es& 1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compiiance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> "*"PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Fiil out application completely. <br /> Owner 8 Contractor sign back of appl(cation,notarized <br /> If over$2500,a Notice of Commencement is required. (A!C upgrades over;7500) <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 />