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s�s-�so-oozo City of Zephyrhills Permit Appiication Fax-813-780-0021 <br /> , Building Department <br /> Date Received Phone Contact for Permittin -- <br /> Owner's Name Q �/'cv�'�`/? Owner Phone Number /��O '���(J'�� <br /> Owner's Address �o��� V�� ��°� d%i Owner Phone Number <br /> Fee Simple Titleholder Name Owner Phone Number � <br /> Fee Simple Titleholder Addresa <br /> JOB ADDRESS l4 /w' � �!G'�e.'S g LOT# � <br /> SUBDIVISION ��vP'�— ��/��� PARCEL ID# <br /> (OBTAINED FROM PROPERTY TAX NO710E) <br /> WORK PROPOSED B NEW CONS7R e ADD/ALT Q SIGN 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 WORK /T G cIl2 � ��� <br /> BUILOING SIZE � .S �'S� SQ FOOTAGE ��Q� HEIGHT <br /> OBUILDING $ VALUATION OF TOTAL CONSTRUCTION <br /> DELECTRICAL $ AMP SERVICE 0 PROGRESS ENERGY Q W.R.E.0 <br /> QPLUMBING $ <br /> [�,�AECHANICAL $ �Q� �2,� VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINiSHED FLOOR ELEVATIONS FLOOD ZONE AREA �YES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address License# � <br /> EI.ECTRICIAN 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 �������"/ � j�1 �-� <br /> SIGNATURE REGISTERED Y! N FEE CURRE� Y/N <br /> Address �a��/ �°���OC �C 33s License# ������v� <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 Forms;R-O-W Permit for new construction, <br /> Minimum ten(10)working days after submittal date. Required onsite,ConstrucUon Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaciliUes 8 1 dumpster;Site Work Permit for subdivisionsAarge 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 construcUon. <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 /> •"**PROPERT'Y SURVEY required for ail NEW construction. <br /> Directions: <br /> Fill out application completely <br /> Ovmer&Contractor sign back of applicaaon,notartzed <br /> If over E2500,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 Applicatlon Only) <br /> Reroofs if shingles Sewers ServiGe Upgrades A/C Fences(PIoUSurvey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />