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�1 <br /> 813-780-0020 City of Zephyrhills Permit Application �y�t(� ,+ Fax-813-780-0021 <br /> Building Department 1 <br /> Date Received Phone Contact for Permittin - <br /> Owner's Na Q C��'�"�wG s�� �0� Owner Phone Number <br /> � � �Q`W'�� Owner Phone Number � <br /> ,Fp�Sim�la Titlaho�a -" � OWner���N mber �— <br /> Fee Simple Titleholder Address ' <br /> JOB ADDRESS ��� Z � T S�'(�,� �Z�- � �I���l�i �l.. LOT# � <br /> SUBDIVISION ��„-���QO� � PARCEL ID# � 2 ~ a- '-Z..� " Cl a (1 •- ��1�14Q — ('jQ 0 <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED B NEW CONSTR 8 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 0 STEEI Q <br /> DESCRIPTION OF WORK S t GS�Q�e�X � S ►'{1/� ' I C <br /> BUILDING SIZE S SQ FOOTAGE� HEIGHT <br /> �BUILDING $ VALUATION OF TOTAL CONSTRUCTION 6 r� /i J V <br /> QELECTRICAL $ AMP SERVICE � PROGRESS ENERGY 0 W.R.E.0 <br /> QPLUMBING $ �� <br /> QMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION • (� <br /> .� <br /> OGAS Q ROOFING Q SPECIALTY Q OTHER <br /> FINISHED FLOOR ELEVATtONS 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 I N FEE CURRE� Y/N <br /> Address License# <br /> MECHANICAL � COMPANY <br /> SIGNATURE REG�STERED Y/ N FEE CURRE� Y/N <br /> Address License# <br /> OTHER Scott Blackman Roofing, �nC. COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N - <br /> Address ��+ FL��6 license# � <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Pertnit 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 subdivlslonsAarge 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 consUuction. <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 Englneered Plans. <br /> ""'PROPERTY SURVEY requ(red for atl NEW construction. <br /> Directions: <br /> Fill out application completely. <br /> Owner&Contractor sign back of application,notarized <br /> If over 52500,a Notice of Commencement is requlred. (A/C upgrades over E7500) <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 /> Drlveways-Not over Counter if on public roadways..needs ROW <br />