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e�s-�eo-oozo City of Zephyrhills Permit Appiication Fax-813-780.0021 <br /> . Bufldfng Department <br /> Date Received 7—�p _ /`{ Phone Contact tor Permittin v�3 2 -- 9a rr <br /> Owner's Name ' �� �ner Phone Number <br /> Owner's Address c�� �Q l2�"� ��� Owner Phone Number � <br /> Fee Simple Titleholder Name Owner Phone Number � � <br /> Fee Simple Titleholder Addresa � <br /> JOB ADDRESS I / � �, LOT# C� <br /> SUBDIVISION � PARCEL ID!!�— <br /> (OBT/VNED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED � NEW CONSTR 8 ADD/ALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE � SFR O COMM � OTHER <br /> TYPE OF CONSTRUCTION � BLOCK Q FRAME � STEEL Q � <br /> DESCRIPTION OF WORK %! r r�r� 2( �( 2 Z <br /> BUILDING SIZE � SQ FOOTAGE� HEIGHT � <br /> OBUILDING S VALUATION OF TOTAL CONSTRUCTION <br /> 2 0. a c� <br /> DELECTRICAL �� AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> OPLUMBING � <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION � ����� <br /> �GAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED F�OOR ELEVI�TIONS FLOOD ZONE AREA QYES NO <br /> r <br /> BUILDER � COMPANY � <br /> SIGNATURE � REGISTERED Y/ N ^ FEE CURRE� Y/N <br /> Address Ucense# � � <br /> ELECTRICIAN COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C —� <br /> PLUMBER � COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO Y/ N FEE CURRE� Y/N <br /> Address License# C <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 Facititles&1 dumpster;Site Work Permlt for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Building Plans plus a Lite Safety Page;(1)set of Energy Forms.R-O-W Permit for new constructlon. <br /> Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Storxnwater Plans w/Silt Fence installed, <br /> Sanitary Facilities 8 1 dumpste�.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 cansUuctlon. <br /> Directlons: <br /> Fill out applicatlon completely. <br /> Ovmer&Contractor sign back of applicallon,notarized <br /> If over 52500,a Notice of Commencement is required. (A/C upgrades over=7500) <br /> " Agent(for the contractl�or)or Power of Attomey(for the owner)would be someone with notarized letter from owner authotizing same <br /> OVER THE COUNTER PEi�AAITTING (Front of Appllcation Only) <br /> Reroofs if shingles Se�vers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Oriveways-Not ov�C7ounter if on public roadways..needs ROW <br /> a./ <br />