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s�3-�so-oo2o City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permitting O �3 �7�a _ so i3 <br /> Owner's Name Cl7Y1Y1')LC.- t. fa-?"/DI�.1di.-� Owner Phone Number <br /> Owner's Address Clr93 �J Owner Phone Number � � <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �/�v {������U �� � �/7/I(S �� •� LOT# � <br /> SUBDIVISION , PARCEL ID# ���l� p�/� � �`' �O(�D��� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED e NEW CONSTR� ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER (-- <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK flJQ e q/P� ����� S �tn S �/�' ��G S S fP_r�'1 <br /> BUILDING SIZE SQ FOOTAGE� HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ AMP SERVICE � PROGRESS ENERGY Q W.R.E.C. <br /> QPLUMBING $ � <br /> • �/� � � <br /> —t /�v <br /> dECHANICAL $ ���r � VALUATION OF MECHANICAL INSTALLATION 5 <br /> �GAS Q ROOFING Q SPECIALTY � OTHER I�� � <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 ' <br /> License# <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL /�/� �— COMPANY A�RS �j�A��'S7 J'�'�'� <br /> SIGNATURE �"�'"� ���-�''�.� REGISTERED Y/ N FEE CURRE� Y/N <br /> Address �'���/����il.� �� / s �3jr�� License# ��C����� <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy FoRns;R-O-W Permit for new construction, <br /> Minimum ten(10)worVcing days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects <br /> COMMERCIAL Attach(3)complete sets of Bullding 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 /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of application,notarized <br /> If over$2500,a Notice of Commencement is required. (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 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 />