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s�s-�ao-oo2o City of Zephyrhills Permit Application �j� �� Fax-813-780-0021 <br /> ' Building Department <br /> Date Received Phone Contact for Permitting 8 3 a -- ` ?,��Q <br /> � 1 � � � I 1 � 1 1 � i 1 <br /> Owner's Name �i�C. �l CQ..nd � Owner Phone Number <br /> Owner's Address ��J'r� V��- �--�' �a-��� �'Q1'�'�'''�{" � <br /> Owner Phone Number <br /> Fee Simple Titleholder Name �— � Owner Phone Number <br /> Fee Simple Titleholder Address —' <br /> JOB ADDRESS ��0 0 �� �1 ��.,J�t.� , �U�,��y r11,I L F'c� 3 35`T � LOT# � <br /> SUBDIVISION c,.r� c� �'r'�h�►�n�� �,5 PARCEL ID# D�-t�- �-�� � ���n— (.X�1 C�Q— OC���� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEw CONSTR e ADD/ALT 0 SIGN Q � DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER Ic � S�{�°y1�', �rcl <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL � _ <br /> DESCRIPTION OF WORK ��`���'���«�f�� W�t ��' �T"' 1 {�+.k-1�?�� ��Jl�;{�y;.� ��''� C'� � f � <br /> BUILDING SIZE SQ FOOTAGE ^`5ov HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY � W R.E.0 <br /> �PLUMBING $ 3�78J C7O � �� <br /> n)U C � �'l �✓ <br /> �MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS � 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 <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> OTHER /1 ���� ��/� ,9�/ COMPANY l� t-► Y"Y? �E/JT�!'�1 PyG'`�, T 1(� <br /> SIGNATURE `L`��f� ����'� REGISTERED / N FEE CURRE� /N <br /> Address 'i���1��-���r.'"Q1°�t far�.e,`i'<xmpn�Fc, 3�l.'3? License# C71C�S�-��f- f��.7 <br /> 1111111111111111111111111111111111111111111111111111111111111111111 <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 /> D�rections:• <br /> Fill out application completely <br /> Owner 8�Contractor sign back of application,notarized <br /> If over s2500,a Notice of Commencement is required. (AIC upgrades over aT500) <br /> " Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER PERMIT7ING (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 />