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tl13-/tlU-UU1U City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> � , Building Department <br /> Date Received Phone Contact for Permfttin -- <br /> Owner's Name �e Owner Phone Number <br /> Owner's Address Owner Phone Number � <br /> Fee Simple Titleholder Name Ovmer Phone Number � <br /> Fee Simpte Titlehoider Address <br /> JOB ADDRESS � � � -?O-'v�c'c S �JC'� LOT# � <br /> SUBDIVISION � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> IMORK PROPOSED e NEW CONSTR e ADD/ALT �_] SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM Q OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME Q STEEL Q <br /> DESCRIPTiON OF WOftK � �4 C� ��l(� ' C�Gty� ,SL(Y��� <br /> BUILDING SIZE SQ FOOTAGE C� HEIGHT <br /> QBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> ELECTRICAL $ Q� �� AMP SERVICE /'D� " PR SS ENERGY Q �V,R.E.C. <br /> �.,�—� / <br /> OPLUMBING $ ��/1�� <br /> 7 <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLA <br /> QGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATIONS FLOOD 20NE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# r— <br /> ELECTRICIAN COMPANY �c/`'� 4 .�/�C �< C- <br /> SIGNATURE - REGISTERED Y/ N FEE CURRE� Y/N <br /> Address 5 License# �� � �vv� �C� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# � <br /> MECHANICAL � COMPANY <br /> SIGNATURE REGISTERED Y I N FEE CURRE� Y/N <br /> Address License# <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE GURREP Y/N <br /> Address License# �— � <br /> RESIDENTIAL ANach(2)Piot Ptans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, <br /> Mfnimum ten(10)virorking days after submfttal date. Required onsite,ConsVuction Plans,Stormwater Plans w/Silt Fence instailed, <br /> Sanitary Fadlities 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 conshuction. <br /> Minimum ten(10)working days aiter submittal date. Required onsite,Construction Plans,Stormwater Plans w!Silt Fence installed, <br /> Sa�itary Facilities 8 1 dumpster.Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineerad Plans. <br /> �w�wPROPERTY SURVEY requfred for all NEW consVucdon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over 52500,a Notice ot Commencement is requlred. (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 PERMITTING (Front of ApplicaUon Only) <br /> Reroofs if shingies Sewers Service Upgrades A/C Fences(Plof/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />