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a�saaa-ao2a City of Zephyrhills Permit Application Fax-813-780-0021 <br /> Building Department <br /> Date Receiwad • <br /> Phone Contact for Permittin __ <br /> Owner's Name � t,� �C y'� Owner Phone Number <br /> Owner's Address C�� �J ( '��1 s� Owner Phone Number C <br /> Fee Simple Titleholder Name Owner Phone Number C <br /> Fee Simple Titleholder Address <br /> JOB ADDRESS �J �"( T LOT# �� <br /> SUBDIVISION PARCEL ID# <br /> (OBTAINED FR�OM pROPERTY TAX NoricE)DEMOLISH <br /> WORK PROPOSED NEW CONSTR ADD/ALT �� SIGN �J <br /> INSTALL 8 REPAIR <br /> PROPOSED USE Q SFR Q COMM � OTHER <br /> TYPE OF CONSTRUCTION Q BLOCK Q FRAME � STEEI Q � <br /> DESCRIPTION OF WORK pq n� f ��,�C� <br /> BUILDING SIZE �--� gQ FOO AGE�� <br /> HEIGHT ] <br /> QBUILDING $ <br /> VALUATION OF TOTAL CONSTRUCTION <br /> �ELECTRICAL $ � �� AMP SERVICE Q PROGRESS ENERGY [_] W.R.E.0 <br /> . <br /> QPLUMBING $ <br /> .�(�- 1� r <br /> OMECHANICAL $ VALUATION OF MECHANICAL INSTALLATION <br /> OGAS Q ROOFING Q SPECIALTY 0 OTHER � <br /> FINISHED FLOOR ELEVATIONS ( ��� <br /> FLOOD ZONE AREA QYES NO <br /> BUILDER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> ELECTRICIAN COMPANY `YI'ti�'�� n���G�f"/�C..c�"'�1 L <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y I N <br /> Address � D �� 3 3r License# �—�3 D Q� �'� <br /> PLUMBER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C —� <br /> MECHANICAL COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> OTHER COMPANY <br /> SIGNATURE REGISTERED Y/ N FEE CURRE� Y/N <br /> Address License# C <br /> RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construc.tion, <br /> Minimum ten(10)working days after submittal date. Requtred onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, <br /> Sanitary Facflfties&1 dumpster;Site Work Permit for subdivisionsllarge projects <br /> COMMERCIAL Attach(3)complete sets of Buildfng Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Pemiit 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 musC meet compliance <br /> SIGN PERMIT Attach(2)sets of Engineered Plans. <br /> '""'PROPERTY SURVEY required for all NEW construcUon. <br /> Directions: <br /> Fill out application completely. <br /> Owner 8 Contractor sign back of appiicaHon,notarized <br /> If over 52500,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(Plot/Survey/Footage) <br /> Driveways-Not over Counter if on public roadvways..needs ROW <br />