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a�s-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received phone Contact for Permittin - <br /> Owner's Name ��G�Q �l Owner Phone Number $l��"�( �'- ( ( a. <br /> Owner's Address ���5 3 ��h ' h � 1C� Owner Phone Number � —1 <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titlehoider Address <br /> JOB ADDRESS �'I �vU lp���" LOT# �� <br /> SUBDIVISION � � PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROP03ED � NEW CONSTR e ADD/ALT 0 SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM 0 OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK a r c ��C�Yt e (��" �'�y� �,j��,;,,� <br /> BUILDING SIZE —� SQ FOOTAGE�� HEIGHT <br /> 0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ <br /> OMECHANICAL $ �` ���� <br /> aQ�U s VALUATION OF MECHANICAL INSTALLATION <br /> QGAS Q 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 �(iZ Tr V\C2 07� .Pc�SCO <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address •�+ ��G� `aU ZE���(Z�(LL.� � License# C�L ��(5��{g � <br /> ' 3>S j� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Ptans;(2)sets of Building Plans;(1)set of Energy Fonns;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 8�1 dumpster Site Work Permit for all new proJects.All commercial requirements must meet compliance <br /> SIGN PERMIT Attach(2)sets of Engi�eered Plans. <br /> **"'PROPERTY SURVEY required for all NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of applicadon,notarized <br /> If over s2500,a Notice of Commencement is required. (A!C upgrades over ET500) <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 Application Oniy) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />