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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Receiv�d � -� � �! Phone Contact for Permittln _ <br /> Owner's Name - ����� Owner Phone Number �'I 3 �.SD3–a � <br /> ---�.� <br /> Owner's Address y y g 1��h Zp � � ;��s' � ���'y� p�er Phone Number ��'Sl3� °�79-�, �� <br /> ���_ <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Tltleholder Address <br /> —JOB ADDRESS �� � /�I��' 77` iZlv /' i� IS �• 3 i � LOT# C� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEW CONSTR ADD/ALT � SIGN Q [� DEMOLISH <br /> � INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CON3TRUCTION Q BLOCK Q FRAME � STEEL Q <br /> �DESCRIPTION OF WORK f��O S�1�CQ I�QCcY'C� O� }�OQ rL'� -���C�' ,�,�Gl'�'` X 6"FY . <br /> BUILDING SIZE � SQ FOOTAGE�� HEIGHT <br /> QBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> � `��65 60 <br /> QELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY [� W.R.E.C. <br /> QPLUMBING $ <br /> �� P ���, <br /> MECHANICAL �' i �� <br /> � $ VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q ROOFING Q SPECIALTY � OTHER "� + -� � �' �j`1�� <br /> FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA QYES NO � � <br /> c�.3(P�1 <br /> BUILDER – � � � COMPANY �to�►�e�n�2 <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 L(cense# <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 constructio�, <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Fadlities 8 1 dumpster;Site Work Permit for subdivisionsAarge proJects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pertnit for new construction. <br /> Minlmum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facitities 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 construcdon. <br /> Directlons: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Nottce 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 PERMI7TING (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 />