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s�saeo-oozo City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> Building Department <br /> Date Received � —� — 3 phons Contact for Permittin i ��! �j y� <br /> Owne�'s Name �J S E� � � Owner Phone Number y �Zj ' S� �/d <br /> Owner's Address � � � � � <br /> Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS � 6 � Y � / LOT�t � <br /> SUBDIVISION r— PARCEL ID��— <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR e ADD/ALT � SIGN Q [� DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q � <br /> DESCRIPTION OF WORK p!/���0 � ��N'(! _��, I•�� � <br /> BUILDING SIZE $Q FOOTAGE� HEIGHT � <br /> �'�ILDING � - "- <br /> [.�(�� �v' VALUATION OF TOTAL CONSTRUCTION <br /> _ � „�. <br /> �LECTRICAL $ AMP SERVICE Q ESS RGY Q W.R.E.C. <br /> PLUMBING $ ' �� �i ,� �` � <br /> ; ;� � �U �-� <br /> M CHANICAL � <br /> � E $ V UATIO MECk#RNICAL TAL � <br /> ��" <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER � <br /> FINISHED FLOOR EIEVATIONS FLOOD ZONE AREA QYES '- <br /> � <br /> BUILDER � ,�(� COMPANY ti' <br /> SIGNATURE = I REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C —� <br /> ELECTRICIAN � COMPANY -� <br /> SIGNATURE U REG�STERED Y 1 FEE CURREh 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 2,� <br /> SIGNATURE � � REGISTERED Y/ N FEE CURRE� Y/N <br /> < <br /> Address License# C <br /> OTHER COMPANY <br /> SIGNATURE REGISTEREO 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-0-W Permit for new construction, <br /> Minimum ten(10)worlcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facllities 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 aRer submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sanitary Facilities 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 consUuction. <br /> Directions: <br /> Fill out application c�mmpletely. <br /> Owner&Contractor sign back of application,nota�ized <br /> If over 52500,a Not6ce of Commencemsn!is requlred. (A/C upgrades over 57500) • <br /> " Agent(for the contractor)or Power of/tttomey(for the owner)would be someone with notarized letter from owner authorizing same <br /> OVER THE COUNTER P�RMITTING (Front of Appllcation Onty) <br /> Reroofs if shingles Sewers Service Upgrades i4/C Fences(P(oUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />