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813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Received Phone Contact for Permittin �f/J (��� "�j�0� <br /> Owner's Name �-�'�i'fl ��� ��� /�/•� Owner Phone Number 1(13 'lQ(��� �JS�� <br /> Owner's Address �O l 1 � u "' f'N� • Owner Phone Number —� <br /> Fee Simpie Titleholde�Name - - Owner Phone Numbe� —� <br /> Fee Simple Titleholder Address �• <br /> JOB ADDRESS 'J��I l� ���` J�V� , _ Y� 1 FL �3�'JN LOT# �� <br /> SUBDIVISION PARCEL ID# Q�--Z� ^2� - �Q 0�" vD 2-OO�- U 2l� <br /> (OBTAINED FROM PROPERTY TAX NOTICE) <br /> WORK PROPOSED NEw CONSTR ADD/ALT � SIGN Q Q DEMOLISH <br /> INSTALL /� REPAIR <br /> PROPOSED USE � SFR Q COMM C� OTHER <br /> TYPE OF CONSTRUCTION BLOCK Q FRAME � STEEL Q <br /> DESCRIPTION OF WORK d C�6� ��C��� �'�'1 b � ,1 IpQ L(� C'�,�- l <br /> BUILDING SIZE -� SQ FOOTAGE� HEIGHT <br /> QBUILDING $ � VALUATION OF TOTAL CONSTRUCTION <br /> QELECTRICAL $ AMP SERVICE Q PROGRESS ENERGY [J W.R.E.C. <br /> QPLUMBING $ �� ���� <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> �GAS Q ROOFING Q SPECIALTY � OTHER <br /> FINISHED FLOOR ELEVATIONS � FLOOD ZONE AREA QYES NO <br /> BUILDER ��a � � � � COMPANY �'�G�tTYI�-✓ <br /> SIGNATURE �.� ` REGISTERED Y/ N FEE CURRE� Y/N <br /> Add�ess 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 <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address License# � <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,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary FaGlitfes&1 dumpster;Site Work Permit for subdivisionsflarge 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 Faciiities&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 atl NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of appflcation,notarized <br /> If over 52500,a Notice of Commencement is required. (AJC 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 PERM�TTING (Front of Application Only) <br /> Reroofs if shingles Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadways..needs ROW <br />